Aspiration pneumonia is caused by foreign bodies entering the lungs, often food particles or pills, and can be complicated by high acidity and anaerobic bacteria. It affects the bronchioles and alveoli, causing reduced airspace and chest congestion. Symptoms include cough, fever, and shortness of breath. Treatment involves stabilizing the airways and administering antibiotics or corticosteroids.
Aspiration pneumonia is a form of bronchopneumonia, an inflammation of the bronchioles of the lungs, caused by foreign bodies being aspirated or breathed into the lungs. The condition is often caused by food particles or pills, saliva, nasal secretions, or bile. It can be complicated by the high acidity of the aspirated material and the presence of anaerobic bacteria normally present in the human mouth.
The lungs contain a branching structure of airways called bronchi. The smaller branches of the bronchi, which begin at the point where there is no more cartilage in the airways, are called bronchioles. The bronchioles terminate at the alveolar sacs or alveoli, the site of gas exchange in the lungs, where blood is oxygenated. The bronchioles and alveoli are the structures affected in aspiration pneumonia.
Aspiration pneumonia, like other forms of bronchopneumonia, is acute inflammation of the bronchioles that leads to an immune response in which the alveoli fill with fluid. This results in reduced airspace in the lungs and chest congestion. Chemical inflammation can also be present if an acidic substance is breathed into the lungs. The location of the pneumonia in the lungs depends on the severity, so it appears lower in the lungs in patients aspirating in the upright position and higher in the lungs in patients aspirating in the prone position.
This type of pneumonia is often caused by impaired swallowing, such as in a person who is drunk or has suffered neurological damage such as a stroke. It is also a possible complication of surgery under general anesthesia. It is therefore recommended that patients undergoing general anesthesia refrain from eating or drinking anything for a certain number of hours before surgery.
The bacteria most commonly found in aspiration pneumonia are those that are normally found in the mouth. These include bacteria of the genera Bacteriodes, Prevotella and Peptostreptococcus. These bacteria are anaerobic, meaning they don’t need oxygen to survive, but aerotolerant, meaning they can live in the presence of oxygen. Bacterial pathogens can also contribute to aspiration pneumonia. These can include Fusobacterium species, as well as aerobic bacteria that require oxygen to survive, such as Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Haemophilus influenzae.
Aspiration pneumonia causes symptoms including cough, fever, pain and weakness, shortness of breath, headache, nausea, and weight loss. The first line of treatment is to stabilize the airways and provide lost fluids and electrolytes intravenously. The airways can be stabilized by suction and, if necessary, by the use of a breathing tube. Antibiotics or corticosteroids can be used to fight the bacterial infection in the lungs.
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