Aspiration Pneumonia

What is aspiration pneumonia?

Aspiration pneumonia is a bacterial infection in your lungs. It can happen when you aspirate, or inhale, something other than air into your respiratory tract. This can be food, liquid, saliva, stomach acid, vomit or even a small foreign object.

You’ve probably had something “go down the wrong pipe” — meaning that food or liquid went down your windpipe (toward your lungs) instead of your esophagus (toward your stomach). When this happens, your body reacts and you cough it out. But for some people, they’re unable to get it out, and something ends up in their lungs that doesn’t belong there. This can cause bacteria to grow, causing an infection (pneumonia).

Many people with aspiration pneumonia don’t realize this has happened — called silent aspiration. The infection can develop days or even weeks after aspirating.

What are the symptoms of aspiration pneumonia?

Symptoms of aspiration pneumonia include:

• Fever
• 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?

It may take days or weeks for symptoms of pneumonia to develop after you aspirate something. Remember that people with aspiration pneumonia often don’t realize that they aspirated anything.

What causes aspiration pneumonia?

Inhaling something into your lungs that shouldn’t be there can lead to aspiration pneumonia — especially if you’re unable to cough it out (or you don’t notice). Anything that’s not air can bring bacteria with it, which causes the infection.

Things that can get into your lungs that can cause pneumonia include:

• Saliva and mucus from your mouth and nose
• Stomach acid
• Vomit
• Food or beverages
• Small objects

Who’s at higher risk for aspiration pneumonia?

You’re at a higher risk for aspiration pneumonia if you:

• Have had general anesthesia or dental procedures recently
• Have trouble coughing or swallowing (dysphagia), which can happen after stroke or brain injury, or if you have a nervous system disorder like Parkinson’s disease or multiple sclerosis
• Are impaired by alcoholic beverages or drugs
• Are older than 65 or younger than 5
• Live in an assisted living facility or nursing home
• Have a weakened immune system

What are the complications of aspiration pneumonia?

Aspiration pneumonia can lead to sepsis — a life-threatening reaction to an infection — and respiratory failure.

How is aspiration pneumonia diagnosed?

To diagnose aspiration pneumonia, your provider will ask you about your symptoms and your medical history. They may ask about any conditions that affect your ability to swallow or cough. Tests that can help providers diagnose aspiration pneumonia include:

• Imaging. This could include chest X-rays or a CT scan.
• Blood tests. Blood tests can look for signs of infection.
• Sputum tests. You cough up mucus from your lungs for your provider to test for bacteria.
• Bronchoscopy. A provider uses a thin tube (bronchoscope) to look inside your lungs.
• Swallowing studies. Your provider might recommend an evaluation by a speech pathologist or an esophagram (barium swallow test) to diagnose swallowing issues.

How is aspiration pneumonia treated?

Providers usually treat aspiration pneumonia with antibiotics. Depending on how severe your symptoms are, you might also need oxygen therapy or mechanical ventilation while the antibiotics work.

If you have an ongoing condition that increases your risk for aspiration, you might need treatment for the underlying cause. Depending on the cause, treatments could include:

• Speech therapy
• Tube feeding
• ACE inhibitors

Can aspiration pneumonia be prevented?

To reduce your risk of aspiration (which can lead to pneumonia), you can:

• Manage any underlying medical conditions that can lead to aspiration, which include GERD (chronic acid reflux) and conditions that affect your ability to swallow or cough
• Avoid drinking alcohol to excess
• Stay upright when you’re eating and drinking
• Chew slowly and completely
• Avoid smoking, vaping and using nicotine products
• Avoid illegal drug use and misusing prescription drugs
• Practice good dental hygiene and visit your dentist regularly

How long will it take me to recover from aspiration pneumonia?

It might take you a week or so after starting antibiotics to start to feel better. Many people are still tired up to a month into recovery.

If you have an underlying medical condition that causes frequent aspiration, you’ll need to work closely with a healthcare provider to manage it.

What are the chances of surviving aspiration pneumonia?

Most people survive aspiration pneumonia. Mortality (death rate) depends on the severity of the disease and other health conditions (comorbidities).

When should I see my healthcare provider?

If you often feel like you’re choking or you have difficulty swallowing, see your provider. You may need to see a specialist who can help diagnose and treat underlying conditions.

When should I go to the ER?

Call 911 or your local emergency services number or go to the emergency room if you have symptoms like chest pain, fever and difficulty breathing. Pneumonia can get worse quickly.

What questions should I ask my doctor?

It might be helpful to ask your provider:

• What caused this?
• Could it happen again?
• What are my treatment options?
• Do I need additional tests to look for conditions that lead to aspiration?
• When should I follow up with you?

What’s the difference between aspiration pneumonia and aspiration pneumonitis?

Aspiration pneumonia is sometimes confused with aspiration pneumonitis. An infection causes aspiration pneumonia. Aspiration pneumonitis is inflammation in your lungs without an infection.