What is Aspiration Pneumonia?
Aspiration pneumonia is a type of pneumonia that occurs if a person accidentally breathes something into the lungs. It can be anything like food, saliva, vomit, or medication, which brings infection into the lungs. It is not like other pneumonia that occurs after a bacterial infection.
Healthy lungs are able to get rid of the bacterial infection from these types of accidents through a cough.
People with troubled cough are already ill. Their immune system is already compromised and therefore are more prone to aspiration pneumonia.
About 18% of aspiration pneumonia cases occur in a nursing home and in 5-15% of all community-acquired pneumonia.(1)
Causes and Risk Factors of Aspiration Pneumonia
The only cause of aspiration pneumonia is breathing in of any substance like food, drink, or medication into the lungs. These substances may cause bacterial growth and lead to non-contagious infection.
There are many factors, depending on which the germs infecting the lungs may increase. Most of the infection is due to Streptococcus pneumonia, Staphylococcus aureus, or gram-negative bacteria.
Aspiration pneumonia is seen to be most common in people with dysphagia. There are several conditions that can cause dysphagia and increase the risk of aspiration pneumonia. These include:
- Esophageal disorder
- Dental problem
- Stroke
- Seizure
- Heart attack
- Coma
- Muscle relaxers or sedatives
- Gastrointestinal reflux disease
Disorders that may impair the mental state such as dementia
Other risk factors include:
- Age
- Substance use disorder
- Poor gag reflex
Symptoms of Aspiration Pneumonia
There is a range of symptoms that may occur due to aspiration pneumonia, which include:(2)
- Fatigue
- Chest pain
- High fever
- Sweating
- Shortness of breath
- Slight blue skin
If anyone has these symptoms, they should immediately contact a doctor for proper diagnosis and treatment.
If a child or older adult has colored phlegm or high fever, it is important to take them to urgent care.
A person can die due to aspiration pneumonia. Therefore, doctors address this problem as soon as possible. It is estimated that around 11-20% of people die due to aspiration pneumonia.(2)
Diagnosis of Aspiration Pneumonia
The aim of doctors is to diagnose and treat aspiration pneumonia as soon as possible. The doctor enquires about the symptoms and does a physical exam to check for the signs of pneumonia.
There may be cracking in the lungs when a person breathes or a person may have difficulty in breathing.
X-rays and CT scans can provide images of the lungs.(3) A bronchoscope can also be used to look into the airways for any block.
Tests including sputum tests, complete blood count, or arterial blood gas can be helpful in checking how severe the infection is and what type of treatment may be needed.
Esophageal or barium swallow is a test that involves a special x-ray of the esophagus or pharyngeal manometry. It measures the pressure in the esophagus.
Treatment for Aspiration Pneumonia
The treatment for aspiration pneumonia varies for people. It may be given according to the severity of the symptoms.
Antibiotics are given to clear off infection and avoid any serious complications. The patient is recommended to raise the bed to 45 degrees and oxygen is provided.
Some people may need hospitalization for long periods to check blood oxygen levels. Those with breathing difficulties may need a breathing machine. Those with difficulty in swallowing are recommended assisted feeding methods or a change in eating habits to prevent further aspiration.
Complications of Aspiration Pneumonia
Aspiration pneumonia may lead to severe complications as the infection of the lungs may spread to other areas of the body. It may even spread to the bloodstream, which can be more dangerous.
In some cases, pneumonia may lead to respiratory failure and even death.
The diseases that may affect swallowing may further worsen aspiration pneumonia.
Outlook for Aspiration Pneumonia
The outlook for aspiration pneumonia depends on the following factors:
- Symptoms
- How early the person went to the doctor
- Progression of symptoms
- General health before getting pneumonia
- Type of object inhales
- Strain of infection
Most people survive aspiration pneumonia, while it is estimated that 11-30% of people pass away. Complete recovery might take time.
It is important for a person to follow a proper treatment plan for the best recovery. Lifestyle changes such as improving hygiene, eating slowly, and avoiding foods can be helpful in preventing aspiration pneumonia.