Aspiration pneumonia bacterial infection: Difference between revisions
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* Expectorated sputum is not used as an diagnostic tools as contamination by the normal flora of the mouth and airways is inevitable. | * Expectorated sputum is not used as an diagnostic tools as contamination by the normal flora of the mouth and airways is inevitable. | ||
* Specimen obtained via bronchoscopy may be suitable but limited studies are available to prove this. | * Specimen obtained via bronchoscopy may be suitable but limited studies are available to prove this. | ||
==Chest X Ray== | ==Chest X Ray== | ||
Revision as of 19:18, 8 September 2012
| Aspiration pneumonia bacterial infection | ||
| ICD-10 | J12, J13, J14, J15, J16, J17, J18, P23 | |
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| ICD-9 | 480-486, 770.0 | |
| DiseasesDB | 10166 | |
| MeSH | pneumonia bacterial infection&field=entry#TreeC08.381.677 C08.381.677 | |
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Aspiration pneumonia bacterial infection Microchapters |
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Differentiating Aspiration pneumonia bacterial infection from other Diseases |
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Diagnosis |
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Treatment |
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Aspiration pneumonia bacterial infection On the Web |
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American Roentgen Ray Society Images of Aspiration pneumonia bacterial infection |
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Directions to Hospitals Treating Aspiration pneumonia bacterial infection |
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Risk calculators and risk factors for Aspiration pneumonia bacterial infection |
For patient information click here
Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Aspiration pneumonia bacterial infection from other Diseases
Epidemiology and Demographics
Risk factors
Natural History, Complications and Prognosis
Prognosis predictor scores: CURB-65 | Aspiration pneumonia bacterial infection severity index | Criteria for severe community acquired Aspiration pneumonia bacterial infection
Diagnosis
Diagnostic criteria | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray
Treatment
Diagnosis
Lab diagnosis
Sputum culture
- Expectorated sputum is not used as an diagnostic tools as contamination by the normal flora of the mouth and airways is inevitable.
- Specimen obtained via bronchoscopy may be suitable but limited studies are available to prove this.
Chest X Ray
- Lung abscess
- Empyema
- Involvement of dependent pulmonary lobes i.e., upright position lower lobe, superior segment of lower lobes or posterior segment of upper lobes in recumbent position
Natural History, Complications and Prognosis
- Lung abscess
- Necrotizing pneumonia
- Empyema
- Bronchopleural fistula
Risk factors
- Poor dental hygiene is a risk factor
- Patients with good dental hygiene and edentulous are less predisposed
Treatment
Medical therapy
Antibiotics
- Treatment of choice clindamycin
- Doses 600 mg Q8hourly, followed by 300 mg Q6hourly, or 450 mg tid
- Advantage of clindamycin :
- Cheap
- Less incidences of superimposed MRSA
- Other agents used: Ampicillin-sulbactam (1.5 g or 3 g twice daily), Imipenem (Invanz 500 mg BID), amoxicillin-clavulnate (875 mg orally bid), penicillin (1 to 2 million units IV Q6hourly) / amoxicillin (500 mg orally tid)+ metronidazole (500 mg orally or IV tid).
- Monotherapy with metronidazole is not preferred as high failure rates have been reported. This is because metronidazole is ineffective against some pathogens such as microaerophilic and aerobic streptococci