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

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

References

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