What is aspiration pneumonia?
Aspiration pneumonia is an
inflammation of your lungs and bronchial tubes that occurs after you inhale
oral or gastric contents. Though it is not the most common type of pneumonia,
it is not unusual to contract aspiration pneumonia.
Aspiration pneumonia is
caused by inhaling materials such as vomit, food, or liquid. Your mouth and
throat normally contain many species of bacteria that are aspirated along with
the oral or gastric contents. These bacteria can grow in the lungs, which
becomes pneumonia. The types of bacteria that most often cause this kind of
pneumonia are known as anaerobic bacteria. This includes peptostreptococcus,
bacteroides and Prevotella bacteria families. E.
coli can also be the culprit. It is important to remember that the oral or
gastric contents can damage the lung tissue as well and cause inflammation
known as chemical pneumonitis.
More commonly found kinds
of bacterial pneumonia, known as community-acquired pneumonia (CAP), are
usually caused by streptococcus and pneumococcus bacterias.
accounts for as much as 15 percent of pneumonia cases acquired outside of hospitals.
causes aspiration pneumonia?
Aspiration generally leads
to bacterial pneumonia along with some degree of chemical pneumonitis. Viruses
and fungi can also cause pneumonia but not generally with aspiration. Your immune system usually fights these invaders
off, preventing them from infecting your lungs. However, there are occasions
when the germs can overpower the immune system.
Under normal circumstances,
only air should enter the lungs. Aspiration pneumonia is more likely to occur
if something is preventing your normal gag reflex. This can be due to a brain
injury (which can occur due to stroke or trauma), medical conditions such as
myasthenia gravis, Parkinson’s disease, dementia, multiple sclerosis (MS), and amyotrophic
lateral sclerosis (ALS or Lou Gehrig’s disease), or even excessive use of
alcohol, prescription, or illegal drugs. Aspiration pneumonia can also be
associated with esophageal disorders, anesthesia, and dental problems that
interfere with chewing or swallowing. Sometimes, the swallowing muscles can
become weak with age or inactivity, for example, a patient who is on mechanical
ventilation for several days or longer. Aspiration can occur in these situations
as well. Finally, persons with normal swallowing and a normal gag reflex can
aspirate and develop pneumonia if their food or drink simply “goes down the
people can effectively expel enough of the aspirate to prevent pneumonia by
creating a strong cough, but some people have an impaired coughing ability.
This is especially common in people who are unconscious or have brain injuries that
lead to a decreased level of consciousness. Many of us aspirate small amounts
of saliva each night while sleeping but we do not develop aspiration pneumonia
due both to our ability to clear the aspirate and a fairly healthy immune
system. Persons that are immunocompromised such as those on chemotherapy or
other immunosuppressive drugs are at higher risk for developing pneumonia when
is at risk for aspiration pneumonia?
The highest risk of this
condition is seen in older adults with a history of:
- lung disease
therapy to the head and neck
People with heartburn
(gastroesophageal reflux) and gastroesophageal
reflux disease (GERD) also are at increased risk.
are the symptoms of aspiration pneumonia?
The symptoms of this
condition are similar to other types of pneumonia. They include:
- chest pain
- shortness of
discoloration of the skin
possibly with green sputum, blood, or a foul odor
- bad breath
If you have any of these
symptoms, contact your doctor and let them know if you’ve recently inhaled any
food or liquids.
Anyone that is exhibiting
these symptoms should use caution and contact their doctor. However, it is
especially critical that a child under 2 years old, or an adult over the age of
65, get medical attention and a quick diagnosis. If you are coughing up colored
sputum or have a lingering fever over 102° in addition to the symptoms
mentioned above, do not hesitate to go to the emergency room.
If you think you might
have this condition, talk to your doctor as soon as possible. Prompt treatment
can make a big difference in your recovery.
is aspiration pneumonia diagnosed?
Your doctor might find
additional signs of aspiration pneumonia during a physical exam, such as:
- decreased flow
- rapid heart
sound in the lungs
Your doctor will run a
series of tests to diagnose you. These may include:
- sputum culture
- complete blood
- arterial blood
- CT scan of
- blood culture
- chest X-ray
Your doctor may also need
to test your ability to swallow. They may ask you to take a barium swallow
during your X-ray. This is called a barium swallow study, and it can give your
doctor a better picture of any swallowing problems you may have.
Since pneumonia is a
serious diagnosis that requires treatment, you should have the results of your
tests within 24 hours, if not sooner. However, it may take several kinds of
tests to positively identify aspiration pneumonia.
is aspiration pneumonia treated?
Your treatment will depend
on the severity of your pneumonia. The first line of treatment will probably be
antibiotics. Severe pneumonia may need to be treated in the hospital. People
with trouble swallowing may need to stop taking food by mouth.
Choosing the right
antibiotics can be difficult. The bacteria that cause this condition may be
hard to identify. There are some things your doctor will need to know to
identify the appropriate medication:
- whether you
were recently hospitalized
- your overall
- if you’ve used
- where you live
Antibiotics specific to
aspiration pneumonia will most likely be prescribed to you. They may include clindamycin,
flagyl, zosyn, levaquin, maxipime or rocephin, and merrem. If you are treated
with oral antibiotics at any point in the course of your illness, make sure to
take the antibiotics for the entire length of the prescription period, which
can vary from seven to 14 days.
Aspiration pneumonia can
cause breathing problems, so you may need help to breathe. You may be
prescribed oxygen, steroids, and/or breathing treatments. Mechanical
ventilation may also be used to assist with your breathing if your case is
Outcomes and duration of
treatment vary greatly depending on your general health, pre-existing conditions,
and individual hospital policies.
can aspiration pneumonia be prevented?
You can reduce your risk
of this condition by:
behavior that leads to aspiration, such as excessive drinking
the risks of aspiration in certain situations
proper dental care on a regular basis
If your doctor has
identified that you’re at risk of developing aspiration pneumonia, you should
undergo a comprehensive swallow evaluation. A licensed speech pathologist or
licensed swallow therapist evaluates this comprehensive test.
Those who are at high risk
of aspiration pneumonia should drink alcohol in moderation and be careful with
any medication that may cause sedation. If you are scheduled for elective
surgery, you should also make sure to follow your doctor’s orders about fasting
before surgery. This will help lower the chance that you will vomit under
can be expected in the long term?
Many people who have this
condition also have other diseases that affect swallowing. This can affect
recovery especially if you continue to have significant episodes of aspiration
during the recovery period.
Your overall outlook depends on:
- how much of
your lungs have been affected
- the severity
of the pneumonia
- the type of
bacteria causing the infection
- any underlying
medical condition that compromises your immune system or you ability to swallow
Without the right
treatment, pneumonia can cause long-term problems such as a lung abscess or
permanent scarring. Some people will develop acute respiratory failure. This
could be fatal.
Aspiration pneumonia is a
very serious medical condition, but it’s treatable. If you’re at a high risk,
it’s important to follow the prevention methods and to contact your doctor
immediately if you notice any of the symptoms. Sometimes aspiration pneumonia
can signal other underlying health problems that affect your ability to swallow.
Your doctor may order tests to identify these potential other conditions if
they are suspected.