What is aspiration pneumonia?
Aspiration pneumonia is pneumonia that is caused by something other than air being inhaled (aspirated) into your respiratory tract. These non-air substances can be food, liquid, saliva, stomach contents, toxins or even a small foreign object.
There’s also a condition called aspiration pneumonitis which is caused by the same type of thing happening but there is only inflammation (swelling) and irritation, not infection. It’s difficult to tell the two conditions apart.
Other names for aspiration pneumonia include anaerobic pneumonia, necrotizing pneumonia and aspiration of vomitus.
What is the difference between pneumonia and pneumonitis?
Pneumonitis is a term that refers to inflammation (swelling) of the lungs. Pneumonia is actually a specific type of pneumonitis. In pneumonia, there is the additional factor of infection. The two conditions have similar symptoms and are often difficult to tell apart.
How common is aspiration pneumonia?
Aspiration of food or drink is a relatively common thing. You’ve probably heard someone say that food "went down the wrong pipe,” meaning that food or drink went toward your lungs instead of your stomach. When this happens, you probably coughed until you felt better.
When the same sort of thing happens to someone who isn’t able to cough the food or drink out of their lungs, aspiration pneumonia may result.
Who is most likely to get aspiration pneumonia?
Aspiration pneumonia is more common among people who:
- Have had general anesthesia or dental procedures.
- Have trouble coughing or trouble swallowing. Trouble swallowing is known as dysphagia. These issues are more common among people with brain injury or nervous system disorders like Parkinson’s disease or multiple sclerosis.
- Have been drinking or taking drugs to excess.
- Are older (65 and over). Aspiration pneumonia is more common among people who live in nursing homes.
- Have weak immune systems due to some illness, or underdeveloped immune systems due to being very young (younger than 5 years old).
Symptoms and Causes
What causes aspiration pneumonia?
Aspiration pneumonia is caused by inhaling foreign materials into your lungs. These materials can be:
- Bacteria from saliva and secretions from your mouth and nose.
- Stomach contents such as digestive juices or vomit.
- Food or beverages.
- Small foreign objects.
What are the symptoms of aspiration pneumonia?
Aspiration pneumonia symptoms include:
- Shortness of breath (dyspnea) or wheezing.
- Coughing up blood or pus.
- Chest pain.
- Bad breath.
- Extreme tiredness.
How long does it take for aspiration pneumonia to develop?
Symptoms of aspiration (inhaling something like secretions) start very quickly, even one to two hours after you inhale something you shouldn’t have. It may take a day or two for pneumonia to develop.
Diagnosis and Tests
How is aspiration pneumonia diagnosed?
Generally, the first thing your provider will do in any situation is take a complete medical history and perform a physical examination. They’ll ask you about your current signs and symptoms. One thing that is a little tricky about aspiration pneumonia is that often no one actually sees you breathe in an object or food or saliva.
In addition to taking note of your symptoms, your provider will order tests such as:
- Chest X-ray and/or a computed tomography (CT) scan. In cases of aspiration pneumonia, inflammation is often seen at the bottom of your lungs.
- Blood tests. These may include a complete blood count.
- Sputum tests. Sputum, or phlegm, is a mixture of saliva and mucus that you produce when you cough.
- Occasionally, you may need a bronchoscopy, a test that uses special equipment (a bronchoscope) to look inside your lungs.
- Swallowing studies.
Management and Treatment
How is aspiration pneumonia treated?
Aspiration pneumonia is treated primarily with antibiotics. (Viral pneumonia requires treatment with antiviral medications.) The choice of antibiotics depends on several things, including any allergies to penicillin and where the pneumonia was acquired. Hospital-acquired infections must be treated with antibiotics that are effective against many types of bacteria.
Even though aspiration pneumonitis isn’t an infection, your provider may start antibiotic therapy, depending on the clinical situation and underlying medical conditions.
Additional treatment might include oxygen therapy or, in life-threatening cases, mechanical ventilation. Mechanical ventilation means that a machine (a ventilator) is breathing for you.
Preventing further aspiration is an important part of treatment, since every episode of aspiration can lead to inflammation or infection.
How can I prevent aspiration pneumonia or reduce my risk of getting aspiration pneumonia?
Things that you can do to reduce your risk of aspiration pneumonia include the following:
- Avoid drinking alcohol to excess and using recreational drugs. These can affect your ability to swallow.
- Stay upright when you are eating.
- Chew slowly and completely.
- If you have problems swallowing (things often “go down the wrong pipe”), talk to your healthcare provider. They might need to change or adjust your diet or medication. They can also order tests or refer you to a speech professional or swallowing specialist.
- Don’t smoke or use nicotine products.
- Take good care of your teeth.
Outlook / Prognosis
What is the outlook (prognosis) if I have aspiration pneumonia?
Most people who get aspiration pneumonia and get treatment will survive. The prognosis for aspiration pneumonia also depends on your overall health and other conditions that you may have and how sick you were when you started treatment.
Untreated aspiration pneumonia can be dangerous, resulting in things like lung abscesses or lung scarring. In fact, it can result in death.
How long will it take me to recover from aspiration pneumonia?
Most people recover from aspiration pneumonia in a week or so with treatment. Although you might be ready to return to work or school, you might still be tired for some time after a week. Many people are still tired up to a month into recovery.
Recurrent aspiration due to underlying medical or neurological conditions can be difficult to treat and needs expert care from a multidisciplinary team.
When should I see my healthcare provider about aspiration pneumonia?
If you have worrisome symptoms like chest pain, fever and difficulty breathing, call your provider or seek emergency medical help. Pneumonia can get worse more quickly than you realize.
If you often feel like you are choking, or have difficulty swallowing, see your provider. You may need to see a specialist who can help you find out why you are choking or having problems swallowing. You may need to change what and how you eat and drink.
A note from Cleveland Clinic
Pneumonia is an infection in your lungs. One of the ways you can get this infection is by inhaling saliva, food, stomach contents or even foreign objects into your lungs, which is called aspiration pneumonia. This type is more common among certain people, including people with nerve disorders or swallowing issues. Aspiration pneumonia is generally treated with antibiotics. Treatment is successful for most people. Make sure you contact your healthcare provider if you have chest pain, fever and difficulty breathing. As with most conditions, the best outcomes happen when aspiration pneumonia is found early.
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