Aspiration pneumonia

Aspiration pneumonia
Microscopic image of aspiration pneumonia in an elderly person with a neurologic illness. Note foreign-body giant cell reaction.
SpecialtyEmergency medicine, pulmonology
SymptomsFever, cough[1]
ComplicationsLung abscess and pneumonia[1]
Usual onsetElderly[2]
Risk factorsDecreased level of consciousness, problems with swallowing, alcoholism, tube feeding, poor oral health[1]
Diagnostic methodBased on presenting history, symptoms, chest X-ray, sputum culture[2][1]
Differential diagnosisChemical pneumonitis, tuberculosis[1][2]
MedicationClindamycin, meropenem, ampicillin/sulbactam, moxifloxacin[1]
Frequency~10% of pneumonia cases requiring hospitalization[1]

Aspiration pneumonia is a type of lung infection that is due to a relatively large amount of material from the stomach or mouth entering the lungs.[1] Signs and symptoms often include fever and cough of relatively rapid onset.[1] Complications may include lung abscess, acute respiratory distress syndrome, empyema, and parapneumonic effusion.[3][1] Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs.[1][2]

Infection can be due to a variety of bacteria.[2] Risk factors include decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, and poor oral health.[1] Diagnosis is typically based on the presenting history, symptoms, chest X-ray, and sputum culture.[1][2] Differentiating from other types of pneumonia may be difficult.[1]

Treatment is typically with antibiotics such as clindamycin, meropenem, ampicillin/sulbactam, or moxifloxacin.[1] For those with only chemical pneumonitis, antibiotics are not typically required.[2] Among people hospitalized with pneumonia, about 10% are due to aspiration.[1] It occurs more often in older people, especially those in nursing homes.[2] Both sexes are equally affected.[2]

  1. ^ a b c d e f g h i j k l m n o p DiBardino DM, Wunderink RG (February 2015). "Aspiration pneumonia: a review of modern trends". Journal of Critical Care. 30 (1): 40–8. doi:10.1016/j.jcrc.2014.07.011. PMID 25129577.
  2. ^ a b c d e f g h i Ferri, Fred F (2017). "Pneumonia, Aspiration". Ferri's Clinical Advisor. Elsevier Health Sciences. p. 1006. ISBN 978-0-323-52957-0.
  3. ^ Sanivarapu, Raghavendra R.; Gibson, Joshua (2023). "Aspiration Pneumonia". StatPearls. StatPearls Publishing. NBK470459.