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