Persistent Hiccups: An Unusual Presentation of Aspiration Pneumonia in the Elderly

Persistent hiccups manifesting as the sole symptom of aspiration pneumonia is a rare occurrence. Approximately 10 cases have been reported in the last 15 years. Hiccups are defined as persistent if it occurs beyond 48 hours and intractable if it occurs continuously for one month. We highlight a case of an elderly man diagnosed with a subacute ischemic infarct of the right occipital lobe with a preserved gag reflex and swallow reflex. The patient's persistent hiccups began eight hours after an emetic episode. Typical signs of pneumonia were absent. Chest x-ray revealed bilateral lower lobe pulmonary infiltrates and he was treated aggressively with intravenous antibiotics and chlorpromazine. He made a full recovery and was discharged four days later.