Aspiration Pneumonia

Definition

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, instead of being swallowed into the esophagus and stomach.

Alternative Names

Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis

Causes

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
• Your recent antibiotic use
• Whether your immune system is weakened

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

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

Symptoms

Symptoms may include any of the following:

• Chest pain
• Coughing up foul-smelling, greenish or dark phlegm (sputum), or phlegm that contains pus or blood
• Fatigue
• Fever
• Shortness of breath
• Wheezing
• Breath odor
• Excessive sweating
• Problems swallowing

Exams and Tests

The health care provider will listen for crackles or abnormal breath sounds when listening to your chest with a stethoscope. Tapping on your chest wall (percussion) helps the provider listen and feel for abnormal sounds in your chest.

If pneumonia is suspected, the provider will likely order a chest x-ray.

The following tests may also help diagnose this condition:

• Arterial blood gas
• Blood culture
• Bronchoscopy (uses a special scope to view the lung airways)
• Complete blood count (CBC)
• CT scan of the chest
• Sputum culture
• Swallowing tests

Treatment

Some people may need to be hospitalized. Treatment depends on how severe the pneumonia is and how ill the person is before the aspiration (chronic illness). Sometimes a ventilator (breathing machine) is needed to support breathing.

You will likely receive antibiotics.

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

Outlook (Prognosis)

Outcome depends on:

• The health of the person before getting pneumonia
• The 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.

Possible Complications

Complications may include:

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

When to Contact a Medical Professional

Call your 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