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Aspiration pneumonia

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

 

Pneumonia is a breathing condition in which there is swelling or an infection of the lungs or large airways.

Aspiration pneumonia occurs when food, saliva, liquids, or vomit is breathed into the lungs or airways leading to the lungs, instead of being swallowed into the esophagus and stomach.

Causes

 

The type of bacteria that caused the pneumonia depends on:

  • Your health
  • Where you live (at home or in a long-term nursing facility, for example)
  • Whether you were recently hospitalized
  • Your recent antibiotic use
  • Whether your immune system is weakened

Risk factors for breathing in ( aspiration ) of foreign material into the lungs are:

  • Being less alert due to medicines, illness, or other reasons
  • Coma
  • Drinking large amounts of alcohol
  • Receiving medicine to put you into a deep sleep for surgery ( general anesthesia )
  • Old age
  • Poor gag reflex in people who are not alert (unconscious or semi-conscious) after a stroke or brain injury
  • Problems with swallowing

 

Symptoms

 

Symptoms may include any of the following:

  • Chest pain
  • Coughing up foul-smelling, greenish or dark phlegm (sputum), or phlegm that contains pus or blood
  • Fatigue
  • Fever
  • Shortness of breath
  • Wheezing
  • Breath odor
  • Excessive sweating
  • Problems swallowing

 

Exams and Tests

 

A physical examination may reveal:

  • Bluish discoloration of the skin caused by lack of oxygen
  • Crackling sounds in the lungs
  • Decreased oxygen
  • Rapid pulse (fast heartbeat)
  • Decreased mental awareness

The following tests may also help diagnose this condition:

  • Arterial blood gas
  • Blood culture
  • Bronchoscopy
  • Chest x-ray
  • Complete blood count ( CBC )
  • CT scan of the chest
  • Sputum culture
  • Swallowing tests

 

Treatment

 

Some people may need to be hospitalized. Treatment depends on how severe the pneumonia is and how ill the person is before the aspiration (chronic illness). Sometimes a ventilator (breathing machine) is needed to support breathing.

You will likely receive antibiotics.

You may need to have your swallowing function tested. People who have trouble swallowing may need to use other feeding methods to reduce the risk of aspiration.

 

Outlook (Prognosis)

 

Outcome depends on:

  • The health of the person before getting pneumonia
  • The type of bacteria causing the pneumonia
  • How much of the lungs are involved

More severe infections may result in long-term damage to the lungs.

 

Possible Complications

 

Complications may include:

  • Lung abscess
  • Shock
  • Spread of infection to the bloodstream ( bacteremia )
  • Spread of infection to other areas of the body
  • Respiratory failure
  • Death

 

When to Contact a Medical Professional

 

Call your health care provider, go to the emergency room, or call the local emergency number (such as 911) if you have:

  • Chest pain
  • Chills
  • Fever
  • Shortness of breath
  • Wheezing

 

 

Open References

References

Musher D. Overview of pneumonia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 97.

Torres A, Menendez R, Wunderink R. Bacterial pneumonia and lung abscess. In: Broaddus VC, Mason RJ, Ernst JD, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 33.

 
  • Pneumococci organism

    Pneumococci organism - illustration

    This picture shows the organism Pneumococci. These bacteria are usually paired (diplococci) or appear in chains. Pneumococci are typically associated with pneumonia, but may cause infection in other organs such as the brain (pneumococcal meningitis) and blood stream (pneumococcal septicemia). (Image courtesy of the Centers for Disease Control and Prevention)

    Pneumococci organism

    illustration

  • Bronchoscopy

    Bronchoscopy - illustration

    Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.

    Bronchoscopy

    illustration

  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Pneumococci organism

      Pneumococci organism - illustration

      This picture shows the organism Pneumococci. These bacteria are usually paired (diplococci) or appear in chains. Pneumococci are typically associated with pneumonia, but may cause infection in other organs such as the brain (pneumococcal meningitis) and blood stream (pneumococcal septicemia). (Image courtesy of the Centers for Disease Control and Prevention)

      Pneumococci organism

      illustration

    • Bronchoscopy

      Bronchoscopy - illustration

      Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.

      Bronchoscopy

      illustration

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

        Tests for Aspiration pneumonia

         
         

        Review Date: 2/2/2015

        Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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