Anaerobic pneumonia
    
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Anaerobic pneumonia

Definition

Aspiration pneumonia is inflammation of the lungs and bronchial tubes due to breathing in a foreign material.

Alternative Names

Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis; Chemical pneumonitis

Causes

Aspiration pneumonia is caused by inhaling foreign material (usually food, liquids, vomit, or secretions from the mouth) into the lungs. This may lead to an inflammatory reaction, a lung infection (pneumonia), or a collection of pus in the lungs (lung abscess).

Aspiration of foreign material (often the stomach contents) into the lung can occur with disorders that affect normal swallowing or disorders of the esophagus (esophageal stricture, gastroesophageal reflux). It also can be caused by a decreased or absent gag reflex in people who are not alert (conscious or semi-conscious).

Old age, dental problems, sedatives, anesthesia, coma, and excessive alcohol use can also lead to this problem. The more acidic the material breathed into the lungs, the more severe the lung injury -- although it may not necessarily lead to pneumonia.

Symptoms

  • Fever
  • Fatigue
  • Cough:
    • With foul-smelling sputum
    • With sputum containing pus or blood
    • With greenish sputum
  • Chest pain
  • Shortness of breath
  • Bluish discoloration of the skin caused by lack of oxygen
  • Rapid pulse (heart rate)
  • Wheezing
Additional symptoms that may be associated with this disease:
  • Sweating, excessive
  • Swallowing difficulty
  • Breath odor

Exams and Tests

Physical examination may reveal crackling sounds in the lungs.

These tests also help diagnose this condition:

  • Chest x-ray
  • Sputum culture
  • CBC
  • Blood culture
  • Bronchoscopy
  • Swallowing studies
  • CT scan of the chest

Treatment

Some people may require hospitalization. Treatment varies depending on the severity of the pneumonia. Antibiotics, which treat the organisms in the environment, may be given. Patients may receive special antibiotics to treat organisms that live in the mouth.

The types of organisms present depend on the patient's health and location (private residence or chronic nursing facility, for instance).

Patients may need to have their swallowing function assessed. If they have trouble swallowing, patients may need to use other feeding methods.

Outlook (Prognosis)

The outcome depends on the severity of the pneumonia, the type of organism, and the extent of lung involvement. If acute respiratory failure develops, the patient may have a prolonged illness or die.

Possible Complications

  • Spread of infection to the blood stream (bacteremia)
  • Spread of infection to other areas of the body
  • Low blood pressure
  • Shock
  • Acute respiratory distress syndrome
  • Pneumonia with lung abscess

When to Contact a Medical Professional

Call your health care provider, go to the emergency room, or call the local emergency number (such as 911) if you have shortness of breath, wheezing, chills, fever, or chest pain.

Prevention

  • Become aware of the risk of aspiration
  • Avoid behaviors that may lead to aspiration

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: Saunders; 2003.

Ferri FF. Ferri's Clinical Advisor 2007. 1st ed. Philadelphia, Pa: Mosby; 2006.

Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

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