DefinitionAspiration pneumonia is inflammation of the lungs and airways to the lungs (bronchial tubes) from breathing in foreign material.Aspiration pneumonia occurs when foreign materials (usually food, liquids, vomit, or fluids from the mouth) are breathed into the lungs or airways leading to the lungs.This may lead to:A collection of pus in the lungs (lung abscess)Swelling and inflammation in the lungA lung infection (pneumonia)
Alternative NamesAnaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis
Causes, incidence, and risk factorsRisk factors for aspiration or breathing in of foreign material into the lungs are:Being less alert due to medicines, illness, or other reasonsComaDisorders of the esophagus, the tube that moves food from the mouth to the stomach (esophageal stricture, gastroesophageal reflux)Drinking large amounts of alcoholMedicine to put you into a deep sleep for surgery (general anesthesia)Old agePoor gag reflex in people who are not alert (unconscious or semi-conscious) after a stroke or brain injury
Problems with swallowing
Acidic material that is breathed into the lungs can cause severe lung injury. However, it may not necessarily lead to pneumonia.
SymptomsBluish discoloration of the skin caused by lack of oxygenChest painCough
With foul-smelling phlegm (sputum)With sputum containing pus or bloodWith greenish sputumFatigueFeverShortness of breathWheezingOther symptoms that can occur with this disease:Breath odorExcessive sweating
Signs and testsA physical examination may reveal:Crackling sounds in the lungsDecreased oxygenRapid pulse (heart rate)The following tests may also help diagnose this condition:Arterial blood gasBlood cultureBronchoscopyChest x-rayComplete blood count (CBC)CT scan of the chestSputum cultureSwallowing studies
TreatmentSome people may need to be hospitalized. Treatment depends on the severity of the pneumonia. You may receive antibiotics, which treat bacteria. Some people may get special antibiotics to treat bacteria that live in the mouth.The type of bacteria that caused the pneumonia depends on:Your healthWhere you live (at home or in a long-term nursing facility, for example)Whether you've recently been hospitalizedRecent antibiotic useYou may need to have your swallowing function tested. Patients who have trouble swallowing may need to use other feeding methods to reduce the risk of aspiration.
Expectations (prognosis)The outcome depends on:The severity of the pneumoniaThe type of bacteria causing the pneumoniaHow much of the lungs are involvedIf acute respiratory failure develops, the patient may have a long-term illness or die.Many people who have aspiration pneumonia have other serious health problems, which may affect the outlook for recovery.
ComplicationsAcute respiratory distress syndromeLow blood pressurePneumonia with lung abscessShockSpread of infection to the bloodstream (bacteremia)Spread of infection to other areas of the body
Calling your health care providerCall your health care provider, go to the emergency room, or call the local emergency number (such as 911) if you have:Chest painChillsFeverShortness of breathWheezing
PreventionAvoid behaviors that may lead to aspiration, such as excessive alcohol useBecome aware of the risk of aspiration
ReferencesDonowitz GR. Acute pneumonia. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 64.Torres A, MenÃ©ndez R, Wunderink R. Pyogenic bacterial pneumonia and lung abscess. In: Mason RJ, Broaddus VC, Martin TR, et a. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.