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Aspiration Pneumonia: Symptoms, Causes, and Treatment

What is aspiration pneumonia?

Fast facts

  1. Aspiration pneumonia is a complication of pulmonary aspiration.
  2. Pulmonary aspiration is when you inhale food, stomach acid, or saliva into your lungs.
  3. Antibiotics are the first-line treatment for aspiration pneumonia.

Aspiration pneumonia is a complication of pulmonary aspiration. Pulmonary aspiration is when you inhale food, stomach acid, or saliva into your lungs. You can also aspirate food that travels back up from your stomach to your esophagus.

All of these things may carry bacteria that affect your lungs. Healthy lungs can clear up on their own. If they don’t, pneumonia can develop as a complication.

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Symptoms

What are the symptoms of aspiration pneumonia?

Someone with aspiration pneumonia may show symptoms of poor oral hygiene and throat clearing or wet coughing after eating. Other symptoms of this condition include:

Anyone exhibiting these symptoms should contact their doctor. Let them know if you’ve recently inhaled any food or liquids. It’s especially critical that children under 2 years of age or adults over the age of 65 get medical attention and a quick diagnosis.

Don’t hesitate to go to the doctor if you’re coughing up colored sputum or have a lingering fever over 102°F (38°C) in addition to the symptoms mentioned above.

Causes

What causes aspiration pneumonia?

Pneumonia from aspiration can occur when your defenses are impaired and the aspirated contents have a large amount of harmful bacteria.

You can aspirate and develop pneumonia if your food or drink “goes down the wrong way.” This may happen even if you can swallow normally and have a regular gag reflex. In that case, most of the time you’ll be able to prevent this by coughing. Those who have impaired coughing ability, however, may not be able to. This impairment may be due to:

  • neurological disorders
  • throat cancer
  • medical conditions like myasthenia gravis or Parkinson’s disease
  • excessive use of alcohol or prescription or illegal drugs
  • use of sedatives or anesthesia
  • a weakened immune system
  • esophageal disorders
  • dental problems that interfere with chewing or swallowing
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Risk factors

Who is at risk for aspiration pneumonia?

Risk factors for aspiration pneumonia include people with:

Diagnosis

How is aspiration pneumonia diagnosed?

Your doctor will look for signs of pneumonia during a physical exam, such as a decreased flow of air, rapid heart rate, and a crackling sound in your lungs. Your doctor may also run a series of tests to confirm pneumonia. These may include:

Because pneumonia is a serious condition, it requires treatment. You should have some of your test results within 24 hours. Blood and sputum cultures will take three to five days.

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Treatment

How is aspiration pneumonia treated?

Treatment depends on the severity of your pneumonia. Outcomes and duration of treatment depend on your general health, preexisting conditions, and hospital policies. Treating severe pneumonia may require hospitalization. People with trouble swallowing may need to stop taking food by mouth.

Your doctor will prescribe antibiotics for your condition. Things your doctor will ask before prescribing antibiotics:

  • Were you recently hospitalized?
  • What is your overall health?
  • Have you used antibiotics recently?
  • Where do you live?

Make sure to take the antibiotics for the entire length of the prescription period. This period can vary from one to two weeks.

You may also need supportive care if aspiration pneumonia causes breathing problems. Treatment includes supplemental oxygen, steroids, or help from a breathing machine. Depending on the cause of chronic aspiration, you may require surgery. For example, you may get surgery for a feeding tube if you have swallowing problems that don’t respond to treatment.

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Prevention

How can aspiration pneumonia be prevented?

Prevention tips
  • Avoid behaviors that can lead to aspiration, such as excessive drinking.
  • Be careful when taking medications that can make you feel drowsy.
  • Receive proper dental care on a regular basis.

Your doctor may recommend a swallow evaluation by a licensed speech pathologist or swallow therapist. They can work with you on swallowing strategies and throat muscle strengthening. You may also need to change your diet.

Surgery risk: Follow your doctor’s orders about fasting to lower the chance of vomiting under anesthesia.

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Outlook

What can be expected in the long term?

Many people who have aspiration pneumonia also have other diseases that affect swallowing. This can result in a longer recovery period. Your outlook depends on:

  • how much of your lungs have been affected
  • the severity of the pneumonia
  • the type of bacteria causing the infection
  • any underlying medical condition that compromises your immune system or your ability to swallow

Pneumonia can cause long-term problems like a lung abscess or permanent scarring. Some people will develop acute respiratory failure, which can be fatal.

Aspiration pneumonia has been shown to increase mortality in people who are hospitalized with community-acquired pneumonia if they aren’t in an intensive care unit (ICU).

Takeaway

Takeaway

Aspiration pneumonia is a lung infection caused by inhaled oral or gastric contents. It can become serious if left untreated. Treatment involves antibiotics and supportive care for breathing.

Your outlook depends on your state of health prior to the event, the type of foreign material that is aspirated into your lungs, and any other conditions you might have. Most people (79 percent) will survive aspiration pneumonia. Of the 21 percent of people who won’t survive, mortality is often due to a preexisting condition that led them to choose to have a DNR (do not resuscitate) or DNI (do not intubate) document.

Contact a doctor immediately if you notice any symptoms of pneumonia, especially in an older adult or infant. To diagnose aspiration pneumonia, your doctor will order tests to look at lung health and ability to swallow.

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