Aspiration pneumonia natural history, complications, and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Aspiration pneumonia occurs following aspiration of different materials and particles. Natural history, complications, and prognosis are different for each category. Chemical pneumonitis usually develop after [[aspiration]] of [[gastric acid]] and might present acutely within two hours. Rapid clinical recovery or worsening of [[Respiratory failure|respiratory distress]] and [[hypoxemia]] might happen. Bacterial infection following aspiration is slower that other community-acquired pneumonia and might be acute, subacute, or chronic. Foreign body aspiration might present acutely with mechanical obstruction or chemical pneumonitis. Patients might present acutely with inflammation and cough, fever, and dyspnea. However, they might be asymptomatic and present with an incidental mass on radiographs. Complications of aspiration pneumonia include segmental or lobar pneumonia, bronchopneumonia, bronchiectasis, lung abscess, empyema, respiratory failure, bacteremia, and shock. | Aspiration pneumonia occurs following aspiration of different materials and particles. Natural history, complications, and prognosis are different for each category. [[Chemical pneumonitis]] usually develop after [[aspiration]] of [[gastric acid]] and might present acutely within two hours. Rapid clinical recovery or worsening of [[Respiratory failure|respiratory distress]] and [[hypoxemia]] might happen. [[Infection|Bacterial infection]] following aspiration is slower that other [[community-acquired pneumonia]] and might be acute, subacute, or chronic. [[Foreign body]] aspiration might present acutely with mechanical [[obstruction]] or [[chemical pneumonitis]]. Patients might present acutely with [[inflammation]] and [[cough]], [[fever]], and [[dyspnea]]. However, they might be [[asymptomatic]] and present with an incidental mass on radiographs. Complications of aspiration pneumonia include segmental or [[Pneumonia|lobar pneumonia]], [[bronchopneumonia]], [[bronchiectasis]], [[lung abscess]], [[empyema]], [[respiratory failure]], [[bacteremia]], and [[shock]]. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
* Aspiration pneumonia occurs following aspiration of different materials and particles. Natural history, complications, and prognosis are different for each category. | |||
==== Chemical pneumonitis ==== | ==== Chemical pneumonitis ==== | ||
* The symptoms of chemical pneumonitis usually develop after [[aspiration]] of [[gastric acid]]. | * The symptoms of [[chemical pneumonitis]] usually develop after [[aspiration]] of [[gastric acid]]. | ||
*Following aspiration, within two hours, [[Respiratory failure|respiratory distress]] and [[cyanosis]] happen. | *Following aspiration, within two hours, [[Respiratory failure|respiratory distress]] and [[cyanosis]] happen. | ||
*The clinical course following chemical pneumonitis might be rapid clinical recovery or worsening of [[Respiratory failure|respiratory distress]] and [[hypoxemia]]. | *The clinical course following [[chemical pneumonitis]] might be rapid clinical recovery or worsening of [[Respiratory failure|respiratory distress]] and [[hypoxemia]]. | ||
*Pulmonary fibrosis might happen even after recovery. | *[[Pulmonary fibrosis]] might happen even after recovery. | ||
==== Bacterial infection ==== | ==== Bacterial infection ==== | ||
*Bacterial infection following aspiration is slower that other community-acquired pneumonia. | *[[Infection|Bacterial infection]] following aspiration is slower that other [[community-acquired pneumonia]]. | ||
*Cough, fever, purulent sputum, and dyspnea are typical symptoms of aspiration pneumonia. | *[[Cough]], [[fever]], purulent [[sputum]], and [[dyspnea]] are typical symptoms of aspiration pneumonia. | ||
*Anaerobic infections might last several days or weeks and patients might present with anemia and weight loss. | *[[Anaerobic respiration|Anaerobic]] infections might last several days or weeks and patients might present with [[anemia]] and [[weight loss]]. | ||
*Patients might present later with following complications including lung abscess, necrotizing pneumonia, or empyema. | *Patients might present later with following complications including [[lung abscess]], necrotizing [[pneumonia]], or [[empyema]]. | ||
==== Foreign body aspiration ==== | ==== Foreign body aspiration ==== | ||
* Foreign body aspiration might present acutely with mechanical obstruction or chemical pneumonitis. | * [[Foreign body]] aspiration might present acutely with mechanical [[obstruction]] or [[chemical pneumonitis]]. | ||
* Foreign body aspiration is more common in children from one to three years of age. | * [[Foreign body]] aspiration is more common in children from one to three years of age. | ||
* | * [[Foreign body]] might be visualized on chest radiographs. | ||
* The Heimlich maneuver is recommended. | * The [[Choking|Heimlich maneuver]] is recommended to remove [[foreign body]] from [[respiratory tract]]. | ||
==== Lipoid Pneumonia ==== | ==== Lipoid Pneumonia ==== | ||
* Lipoid pneumonia might happen following aspiration of oil. | * [[Lipid pneumonia|Lipoid pneumonia]] might happen following aspiration of [[oil]]. | ||
* Patients might present acutely with inflammation and cough, fever, and dyspnea. However, they might be asymptomatic and present with an incidental mass on radiographs. | * Patients might present acutely with [[inflammation]] and [[cough]], [[fever]], and [[dyspnea]]. However, they might be [[asymptomatic]] and present with an incidental mass on radiographs. | ||
===Complications=== | ===Complications=== | ||
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===Prognosis=== | ===Prognosis=== | ||
*Aspiration pneumonia prognosis is generally good, and | *Aspiration pneumonia prognosis is generally good, and [[mortality rate]] of patients with aspiration pneumonia is approximately 10.6-21%.<ref name="LanspaJones20132">{{cite journal|last1=Lanspa|first1=Michael J.|last2=Jones|first2=Barbara E.|last3=Brown|first3=Samuel M.|last4=Dean|first4=Nathan C.|title=Mortality, morbidity, and disease severity of patients with aspiration pneumonia|journal=Journal of Hospital Medicine|volume=8|issue=2|year=2013|pages=83–90|issn=15535592|doi=10.1002/jhm.1996}}</ref> | ||
*The presence of underlying [[Neurology|neurologic diseases]] that affect [[cough reflex]] is associated with a particularly poor prognosis among patients with aspiration pneumonia. | |||
*The presence of [ | |||
==References== | ==References== | ||
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chemical pneumonitisEditor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Aspiration pneumonia occurs following aspiration of different materials and particles. Natural history, complications, and prognosis are different for each category. Chemical pneumonitis usually develop after aspiration of gastric acid and might present acutely within two hours. Rapid clinical recovery or worsening of respiratory distress and hypoxemia might happen. Bacterial infection following aspiration is slower that other community-acquired pneumonia and might be acute, subacute, or chronic. Foreign body aspiration might present acutely with mechanical obstruction or chemical pneumonitis. Patients might present acutely with inflammation and cough, fever, and dyspnea. However, they might be asymptomatic and present with an incidental mass on radiographs. Complications of aspiration pneumonia include segmental or lobar pneumonia, bronchopneumonia, bronchiectasis, lung abscess, empyema, respiratory failure, bacteremia, and shock.
Natural History, Complications, and Prognosis
Natural History
- Aspiration pneumonia occurs following aspiration of different materials and particles. Natural history, complications, and prognosis are different for each category.
Chemical pneumonitis
- The symptoms of chemical pneumonitis usually develop after aspiration of gastric acid.
- Following aspiration, within two hours, respiratory distress and cyanosis happen.
- The clinical course following chemical pneumonitis might be rapid clinical recovery or worsening of respiratory distress and hypoxemia.
- Pulmonary fibrosis might happen even after recovery.
Bacterial infection
- Bacterial infection following aspiration is slower that other community-acquired pneumonia.
- Cough, fever, purulent sputum, and dyspnea are typical symptoms of aspiration pneumonia.
- Anaerobic infections might last several days or weeks and patients might present with anemia and weight loss.
- Patients might present later with following complications including lung abscess, necrotizing pneumonia, or empyema.
Foreign body aspiration
- Foreign body aspiration might present acutely with mechanical obstruction or chemical pneumonitis.
- Foreign body aspiration is more common in children from one to three years of age.
- Foreign body might be visualized on chest radiographs.
- The Heimlich maneuver is recommended to remove foreign body from respiratory tract.
Lipoid Pneumonia
- Lipoid pneumonia might happen following aspiration of oil.
- Patients might present acutely with inflammation and cough, fever, and dyspnea. However, they might be asymptomatic and present with an incidental mass on radiographs.
Complications
- Complications of aspiration pneumonia include:
- Segmental or lobar pneumonia
- Bronchopneumonia
- Bronchiectasis
- Lung abscess
- Empyema
- Respiratory failure
- Bacteremia
- Shock
- Death
Prognosis
- Aspiration pneumonia prognosis is generally good, and mortality rate of patients with aspiration pneumonia is approximately 10.6-21%.[1]
- The presence of underlying neurologic diseases that affect cough reflex is associated with a particularly poor prognosis among patients with aspiration pneumonia.
References
- ↑ Lanspa, Michael J.; Jones, Barbara E.; Brown, Samuel M.; Dean, Nathan C. (2013). "Mortality, morbidity, and disease severity of patients with aspiration pneumonia". Journal of Hospital Medicine. 8 (2): 83–90. doi:10.1002/jhm.1996. ISSN 1553-5592.