Aspiration Pneumonia

Question 1

when does aspiration pneumonia occur

Answer 1

occurs when inhaled oropharyngeal or gastric contents enter the lungs, causing inflammation and infection.

Question 2

what are the types of aspiration pneumonia?

Answer 2

Bacterial pneumonia → Caused by oral/gastric flora (often polymicrobial).
Chemical pneumonitis → Due to gastric acid or irritants, leading to lung inflammation without infection.

Question 3

what are the mild-to-moderate symptoms?

Answer 3

Cough with sputum production
Fever, chills, dyspnea, pleuritic chest pain
Crackles, wheezes, or rhonchi

Question 4

what are the severe symptoms?

Answer 4

Tachypnea, confusion (especially in older adults)
Hypoxia, cyanosis
Hypotension, sepsis, respiratory distress

Question 5

what are the symptoms if it is due to chemical pneumonitis?

Answer 5

Sudden onset of dyspnea, wheezing, and hypoxia
No fever initially

Question 6

what are the risk factors?

Answer 6

Decreased level of consciousness (e.g., stroke, seizure, alcohol intoxication, anesthesia)
Dysphagia (neurologic disorders, esophageal dysfunction)
Gastroesophageal reflux disease (GERD)
Nasogastric (NG) tube use (tube misplacement, poor oral hygiene)
Poor oral hygiene or dental infections

Question 7

what does the chest x ray show?

Answer 7

Right lower lobe infiltrates (most common due to gravity-assisted aspiration)

Question 8

what do additional tests show?

Answer 8

Sputum culture → Polymicrobial infection (gram-negative & anaerobes)
ABGs → Hypoxemia (low PaO₂)
CT scan (if unclear diagnosis or suspected abscess formation)

Question 9

what are the first-line antibiotics for aspiration pneumonia?

Answer 9

Broad-spectrum antibiotics covering anaerobes & gram-negative bacteria:
Piperacillin-tazobactam (Zosyn)
Clindamycin
Carbapenems (meropenem, imipenem)

Question 10

how is chemical pneumonitis treated?

Answer 10

monitor for 48-72 hours

Question 11

what is the supportive care for aspiration pneumonia

Answer 11

Oxygen therapy for hypoxia
IV fluids to maintain hydration and BP
Airway clearance (suctioning) if secretions are excessive
Mechanical ventilation if respiratory failure occurs

Question 12

how is aspiration pneuomnia prevented?

Answer 12

Elevate HOB ≥30° when feeding
Swallow evaluation for high-risk patients
Verify NG tube placement before each feeding
Good oral hygiene (reduces bacterial load)
Use thickened liquids and avoid large bites for dysphagia patients
Supervised eating for patients with swallowing difficulty

Question 13

when should you seek med care?

Answer 13

Worsening dyspnea or severe chest pain
High fever, confusion, or cyanosis
Signs of sepsis (hypotension, tachycardia, altered mental status)