Aspiration pneumonia natural history, complications, and prognosis

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chemical pneumonitisEditor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Natural History, Complications, and Prognosis

Natural History

Chemical pneumonitis

• The symptoms of chemical pneumonitis usually develop after aspiration of gastric acid.
• Following aspiration, within two hours, respiratory distress and cyanosis happen. 
• The clinical course following chemical pneumonitis might be rapid clinical recovery or worsening of respiratory distress and hypoxemia.
• Pulmonary fibrosis might happen even after recovery.

Bacterial infection

• Bacterial infection following aspiration is slower that other community-acquired pneumonia.
• Cough, fever, purulent sputum, and dyspnea are typical symptoms of aspiration pneumonia.
• Anaerobic infections might last several days or weeks and patients might present with anemia and weight loss.
• Patients might present later with following complications including lung abscess, necrotizing pneumonia, or empyema.

Foreign body aspiration

• Foreign body aspiration might present acutely with mechanical obstruction or chemical pneumonitis.
• Foreign body aspiration is more common in children from one to three years of age.
• It might be visualized on chest radiographs.
• The Heimlich maneuver is recommended.

Complications

• Common complications of aspiration pneumonia include:
  • Segmental or lobar pneumonia
  • Bronchopneumonia
  • Bronchiectasis
  • Lung abscess
  • Empyema
  • Respiratory failure
  • Bacteremia
  • Shock
  • Death

Prognosis

• Aspiration pneumonia prognosis is generally good, and the 1/5/10-year mortality/survival rate of patients with aspiration pneumonia is approximately [#]%.
• Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
• The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
• [Subtype of disease/malignancy] is associated with the most favorable prognosis.
• The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.