| Aspiration pneumonia is a precise form of lung infection (pneumonia) that progresses when oral or gastric contents such as (food, saliva, or nasal secretions) go into the bronchial tree. Depending on the acidity of the aspirate, a chemical pneumonitis can result, and bacterial pathogens (particularly anaerobic bacteria) may add to the inflammation.
Aspiration pneumonia is frequently caused by an ineffectual swallowing mechanism, such as occurs in some forms of neurological disease (a common cause is strokes) or while a person is inebriated. An iatrogenic cause is during general anesthesia for an operation and patients are therefore instructed to be nil per os (NPO), nothing in mouth, for at least four hours prior to surgery.
Causes
Whether aspiration pneumonia represents a true bacterial infection or a chemical inflammatory process remains the subject of considerable controversy. Both causes may present with related similar symptoms.
Diagnosis
Diagnosis is made through a physical exam with complete medical history and a chest X-ray. Based solely on the exam, treatment may begin immediately without other tests. More tests are usually needed when symptoms are severe, the patient is very young or older and there are other health risks involved. The sicker a patient is, the more tests that will be used, especially in the geriatric population and infants.
Chest X-rays are used to check for changes in the respiration system that can indicate pneumonia. An X-ray does not always show pneumonia, especially at the beginning stages of the disease. Sometimes an X-ray can indicate the type of organism that is causing the pneumonia, complications, fluid in the chest cavity, a collapsed lung or another condition such as lung cancer or acute bronchitis.
Location
The right lower lobe of the lung is the most frequent location of aspiration pneumonia. This is due to the anatomy of the bronchial tree and gravity: in patients who are upright, the bronchus serving this lobe is leaning almost vertically, leaving it at higher risk to be the target of aspirated secretions.
Treatment:
Antibodies are used to treat bacteria causing pneumonia. Antibiotic treatment can last up to 14 days depending on the medication and the severity of the pneumonia. If the immune system is damaged, the treatment may need to last longer. Antibiotic treatment is chosen based on age of patient, symptoms, severity of symptoms and the need for hospitalization.
A broad spectrum antibiotic that kills a wide range of bacteria is the first choice of treatment. All antibiotics have a high success rate for fighting pneumonia.
If hospitalization is not required, here are some of the antibiotics that are prescribed:
• Tetracyclines, such as doxycycline (Vibramycin, Doryx).
• Macrolides, such as Ery-Tab, Biaxin, Biaxin XL, and Zithromax.
• Fluoroquinolones, such as Levaquin, Avelox, and Tequin.
Patients that stay home, should get plenty of rest and increase their fluid consumption.
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