Aspiration pneumonia

Aspiration pneumonia
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[1]
Complications	Lung abscess[1]
Usual onset	Elderly[2]
Risk factors	Decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, poor oral health[1]
Diagnostic method	Based on presenting history, symptoms, chest X-ray, sputum culture[2][1]
Differential diagnosis	Chemical pneumonitis, tuberculosis[1][2]
Medication	Clindamycin, meropenem, ampicillin/sulbactam, moxifloxacin[1]
Frequency	~10% of pneumonia cases requiring hospitalization[1]

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.^[1] Signs and symptoms often include fever and cough of relatively rapid onset.^[1] Complications may include lung abscess, acute respiratory distress syndrome, empyema, and parapneumonic effusion.^[3][1] Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs.^[1][2]

Infection can be due to a variety of bacteria.^[2] Risk factors include decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, and poor oral health.^[1] Diagnosis is typically based on the presenting history, symptoms, chest X-ray, and sputum culture.^[1][2] Differentiating from other types of pneumonia may be difficult.^[1]

Treatment is typically with antibiotics such as clindamycin, meropenem, ampicillin/sulbactam, or moxifloxacin.^[1] For those with only chemical pneumonitis, antibiotics are not typically required.^[2] Among people hospitalized with pneumonia, about 10% are due to aspiration.^[1] It occurs more often in older people, especially those in nursing homes.^[2] Both sexes are equally affected.^[2]