Aspiration Pneumonia: Symptoms, Causes and Treatment
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Loading ...Aspiration pneumonia
Aspiration pneumonia is a type of secondary pneumonia or pneumonia due to weak host defenses. Aspiration pneumonia is caused by aspiration of organisms (usually anaerobes) into to lower respiratory tract.
Benign aspiration pneumonia
In this type of aspiration pneumonia the cause is due to aspiration of infected nasal secretions into lower respiratory tract
due to coryza or sinusitis. These organisms are usually of low virulence and the degree of systemic disturbance is usually slight. Infact symptoms are often no more severe than lower respiratory tract infections and existence of pneumonia may be discovered only on chest X-ray.
Symptoms of Benign aspiration pneumonia
- Cough
- Purulent sputum
- Low grade fever and
- Sometimes pleuritic chest pain in association with frank upper respiratory tract infection.
- Neutrophilic luecocytosis is usually present.
- Chest X-ray shows unilateral mottled opacity involving a single lobe or segment.
Re-examination 10-14 days later, following treatment with antibiotic usually helps as resolution is generally rapid.
Symptoms of other types of Aspiration Pneumonia
- In other type of aspiration pneumonia there is pneumonic consolidation in which there is destruction of lung parenchyma by inflammatory process.
- Usually caused by staphylococcus aureus or klebsiella pneumoniae.
- These are in effect, primary bacterial pneumonias with pulmonary suppuration.
Causes of aspiration pneumonia
- Altered consciousness.
- Dysphagia and esophageal diseases e.g. tracheo-esphageal fistula.
- Naso-gastric tubes.
- Severe dental and upper airways sepsis- especially during dental extraction.
- Terminal illness.
- Gastro-esophageal reflux during general anesthesia.
Organisms isolated in above cases from sputum include streptococcus pneumoniae, staphylococcus auerus, streptococcus pyogen, haemophilus influenza and few cases anaerobic bacterias.
Clinical features of aspiration pneumonia
- Usually depend on extent of aspiration material into lower respiratory tract.
- Onset may be acute or incidious.
- Cough with purulent sputum, is usually in large amounts which is sometimes foetid and blood stained, is present from an early stage.
- Person has high, remittent fever with shivering and sweating.
- Pleuritic chest pain is common and digital clubbing may be seen 10-14 days after onset of illness.
- Progressive deterioration of general health occurs if person remains untreated.
- Neutrophilic luecocytosis is seen on complete blood count.
- Signs of consolidation or collapse are seen unilaterally involving single lobe or segment. Signs of cavitations are usually not seen.
Prevention of Aspiration Pneumonia
- Every precaution should be taken during surgeries of mouth, nose and throat to prevent inhalation of blood.
- Oral sepsis should be eradicated in case general anesthesia is given.
Treatment of Aspiration Pneumonia
- Rest in bed and ambulation as soon as signs of toxicity disappear.
- Deep breathing exercises.
- Mechanical procedures like broncho-scopic suction for removal of aspirated material to prevent collapse as well as to find the causative organism after sending BAL (brochoscopic aspiration lavage) sample for culture sensitivity.
- Anti-microbial therapy is started at earliest usually based on the type of organism isolated in culture.
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