Health Encyclopedia

Aspiration pneumonia

Definition

Aspiration pneumonia is inflammation of the lungs and bronchial tubes due to breathing in a foreign material.

Alternative Names

Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis; Chemical pneumonitis

Causes, incidence, and risk factors

Aspiration pneumonia is caused by inhaling foreign material (usually food, liquids, vomit, or secretions from the mouth) into the lungs. This may lead to an inflammatory reaction, a lung infection (pneumonia), or a collection of pus in the lungs (lung abscess).

Aspiration of foreign material (often the stomach contents) into the lung can occur with disorders that affect normal swallowing or disorders of the esophagus (esophageal stricture, gastroesophageal reflux). It also can be caused by a decreased or absent gag reflex in people who are not alert (conscious or semi-conscious).

Old age, dental problems, sedatives, anesthesia, coma, and excessive alcohol use can also lead to this problem. The more acidic the material breathed into the lungs, the more severe the lung injury -- although it may not necessarily lead to pneumonia.

Symptoms

Fever
Fatigue
Cough:
- With foul-smelling sputum
- With sputum containing pus or blood
- With greenish sputum
Chest pain
Shortness of breath
Bluish discoloration of the skin caused by lack of oxygen
Rapid pulse (heart rate)
Wheezing

Additional symptoms that may be associated with this disease:

Signs and tests

Physical examination may reveal crackling sounds in the lungs.

These tests also help diagnose this condition:

Chest x-ray
Sputum culture
CBC
Blood culture
Bronchoscopy
Swallowing studies
CT scan of the chest

Treatment

Some people may require hospitalization. Treatment varies depending on the severity of the pneumonia. Antibiotics, which treat the organisms in the environment, may be given. Patients may receive special antibiotics to treat organisms that live in the mouth.

The types of organisms present depend on the patient's health and location (private residence or chronic nursing facility, for instance).

Patients may need to have their swallowing function assessed. If they have trouble swallowing, patients may need to use other feeding methods.

Expectations (prognosis)

The outcome depends on the severity of the pneumonia, the type of organism, and the extent of lung involvement. If acute respiratory failure develops, the patient may have a prolonged illness or die.

Complications

Spread of infection to the blood stream (bacteremia)
Spread of infection to other areas of the body
Low blood pressure
Shock
Acute respiratory distress syndrome
Pneumonia with lung abscess

Calling your health care provider

Call your health care provider, go to the emergency room, or call the local emergency number (such as 911) if you have shortness of breath, wheezing, chills, fever, or chest pain.

Prevention

Become aware of the risk of aspiration
Avoid behaviors that may lead to aspiration

References

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: Saunders; 2003.

Ferri FF. Ferri's Clinical Advisor 2007. 1st ed. Philadelphia, Pa: Mosby; 2006.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

Review Date:3/1/2007
Reviewed By:David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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