Aspiration pneumonitis
| Aspiration pneumonia | |
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| Microscopic image of aspiration pneumonia in an elderly person with a neurologic illness. Note foreign-body giant cell reaction. | |
| Specialty | Emergency medicine, pulmonology |
| Symptoms | Fever, cough |
| Complications | Lung abscess |
| Usual onset | Elderly |
| Risk factors | Decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, poor oral health |
| Diagnostic method | Based on presenting history, symptoms, chest X-ray, sputum culture |
| Similar conditions | Chemical pneumonitis, tuberculosis |
| Medication | Clindamycin, meropenem, ampicillin/sulbactam, moxifloxacin |
| Frequency | ~10% of pneumonia cases requiring hospitalization |
| Classification |
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| External resources |
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. Symptoms often include fever and cough of relatively rapid onset. Complications may include lung abscess. Some include chemical pneumonitis as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs, while other do not.
Infection can be due to a variety of bacteria. Risk factors include decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, and poor oral health. Diagnosis is typically based on the presenting history, symptoms, chest X-ray, and sputum culture. Differentiating from other types of pneumonia may be difficult.
Treatment is typically with antibiotics such as clindamycin, meropenem, ampicillin/sulbactam, or moxifloxacin. For those with only chemical pneumonitis antibiotics are not typically required. Among people hospitalized with pneumonia, about 10% are due to aspiration. It occurs more often in older people, especially those in nursing homes. Both sexes are equally commonly affected.
Aspiration pneumonia is often caused by a defective swallowing mechanism, often due to a neurological disease or as the result of an injury that directly impairs swallowing or interferes with consciousness. Examples of the former are stroke, Parkinson's disease, and multiple sclerosis, and examples of the latter are some types of dementia, seizures, intoxication, and general anaesthesia. For many types of surgical operations, patients are therefore instructed to take nothing by mouth (nil per os, abbreviated as NPO) for at least four hours before surgery.
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