Aspiration pneumonia bacterial infection

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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

Aspiration pneumonia caused by bacterial infection is the commonest subtype of aspiration pneumonia. The other subtypes being chemical pneumonia, and airway obstructions.

Causes

• Normal flora of upper airways, gingival cavity or stomach.
• Caused by less virulent bacteria, such as anaerobes and aerobic or microaerophilic streptococci

History and symptoms

The manifestation depends on:

• The bacteria involved
• Time since aspiration to diagnosis
• Immune status of the host

Symptoms in aerobic microbes

• Abrupt or Indolent course
• Productive cough
• Fever
• Absence of chills and rigors
• Dyspnea
• Anorexia, weight loss
• Anemia

Symptoms in anaerobic microbes

Clinical features, which are characteristic of aspiration pneumonia involving anaerobic bacteria, include:

• Indolent course
• Presence of risk factors: altered sensorium (anesthesia, alcohol, drug, trauma, dysphagia, dental caries)
• Putrid sputum
• Absence of chills and rigors

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