Aspiration pneumonia
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| Aspiration pneumonia Classification and external resources | |
 | |
|---|---|
| Histopathologic image of aspiration pneumonia in an elderly patient with debilitating neurologic illness. Note foreign-body giant cell reaction. Autopsy case. H & E stain. | |
| ICD-10 | J69.0, P24.9 |
| ICD-9 | 507, 770.12, 770.14, 770.16, 770.18 |
| MedlinePlus | 000121 |
| eMedicine | emerg/464 |
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Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign material that enter the bronchial tree, usually oral or gastric contents (including food, saliva, or nasal secretions).[1] Depending on the acidity of the aspirate, a chemical pneumonitis can develop, and bacterial pathogens (particularly anaerobic bacteria) may add to the inflammation.
Causes
Aspiration pneumonia is often caused by an incompetent swallowing mechanism, such as occurs in some forms of neurological disease (a common cause being strokes) or while a person is intoxicated. An iatrogenic cause is during general anaesthesia for an operation and patients are therefore instructed to be nil per os (NPO) for at least four hours before surgery.
Whether aspiration pneumonia represents a true bacterial infection or a chemical inflammatory process remains the subject of significant controversy. Both causes may present with similar symptoms.
Location
The location is often gravity dependent, and depends on the patient position. Generally the right middle and lower lung lobes are the most common sites of infiltrate formation due to the larger caliber and more vertical orientation of the right mainstem bronchus. Patients who aspirate while standing can have bilateral lower lung lobe infiltrates. The right upper lobe is a common area of consolidation in alcoholics who aspirate in the prone position.[1] Depending on the acidity of the aspirate, a chemical pneumonitis can develop, and bacterial pathogens (particularly anaerobic bacteria) may add to the inflammation.
See also
References
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
