Overview of Aspiration Pneumonia

Aspiration is defined as the inhalation of either oropharyngeal or gastric

contents into the lower airways, that is, the act of taking foreign material
into the lungs. This can cause a number of syndromes determined by the
quantity and nature of the aspirated material, the frequency of aspiration,
and the host factors that predispose the patient to aspiration and modify the
response. [1]
There are four types of aspiration syndromes. Aspiration of gastric acid
causes a chemical pneumonitis which has also been called Mendelson
syndrome. [1] Aspiration of bacteria from oral and pharyngeal areas causes
aspiration pneumonia. Aspiration of oil (eg, mineral oil or vegetable oil)
causes exogenous lipoid pneumonia, an unusual form of pneumonia.
Aspiration of a foreign body may cause an acute respiratory emergency
and, in some cases, may predispose the patient to bacterial pneumonia.
The pathophysiology, clinical presentation, treatment, and complications of
each of these entities are different. [2]
This article concentrates on chemical pneumonitis and aspiration
pneumonia.
Aspiration pneumonia is caused by bacteria that normally reside in the oral
and nasal pharynx. Historically, aspiration pneumonia referred to an
infection caused by less virulent bacteria, primarily oral pharyngeal
anaerobes, after a large volume aspiration event. It is now recognized that
many common community-acquired and hospital-acquired pneumonias
result from small-volume aspiration of more virulent pathogens from the
oral cavity or nasopharynx, such as Streptococcus
pneumoniae,Haemophilus influenza, Staphylococcus aureus, and gram-
negative bacteria.
For patient education information, see the Pneumonia Center, as well
as Chemical Pneumonia, Bacterial Pneumonia and Bronchoscopy.
For more information, see the following:
 Mycoplasma Pneumonia
 Bacterial Pneumonia
 Viral Pneumonia
 Pneumocystis Carinii Pneumonia Imaging
 Community-Acquired Pneumonia
 Nosocomial Pneumonia
 Ventilator-Associated Pneumonia
 Pneumocystis jiroveci Pneumonia
 Fungal Pneumonia
 Pneumonia in Immunocompromised Patients
 Nursing Home Acquired Pneumonia
 Chlamydial Pneumonias
 Lymphocytic Interstitial Pneumonia
  Imaging Typical Bacterial Pneumonia
 Atypical Bacterial Pneumonia Imaging
 Viral Pneumonia Imaging
The images below depict aspiration pneumonia in two different patients.

Aspiration pneumonia in an
84-year-old man in generally good health who had fever and cough. This
posteroanterior radiograph demonstrates a left lower lobe opacity.
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Chest radiograph of a
patient with aspiration pneumonia of the left lung after a benzodiazepine
overdose. The patient was probably positioned to the left at the moment of
aspiration
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