Aspiration pneumonia

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.

Causes of Aspiration pneumonia

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
• Recent antibiotic use

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

• Being less alert due to medicines, illness, or other reasons
• Coma
• Drinking large amounts of alcohol
• 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

Aspiration pneumonia Symptoms

• Bluish discoloration of the skin caused by lack of oxygen
• Chest pain
• Coughing up foul-smelling, greenish or dark phlegm (sputum) or phlegm that has pus or blood
• Fatigue
• Fever
• Shortness of breath
• Wheezing
• Breath odor
• Excessive sweating
• Problems swallowing

Tests and Exams

A physical examination may reveal:

• 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 of Aspiration pneumonia

Some people may need to be hospitalized. Treatment depends on how severe the pneumonia is. Sometimes a ventilator (breathing machine) is needed to support breathing.

You will likely receive antibiotics.

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

Prognosis (Outlook)

Outcome depends on:

• Health of the person before getting pneumonia
• 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.

Potential Complications

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

When to Contact a Health 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

References

Limper AH. Overview of pneumonia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 97

Torres A, Menendez R, Wunderink R. Pyogenic bacterial pneumonia and lung abscess. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 32.

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