Aspiration pneumonia refers to the pulmonary effects resulting from an entry of internal or external substances into the lower airway. The most frequently reported forms of aspiration pneumonia are from a bacterial infection resulting from aspirating normal flora bacteria that are normally found in the upper airway.
Aspiration pneumonia often normally occurs in the hospital or community setting and is considered to be one of the most widespread types of infection easily acquired. Common pathogens linked to this type of disease condition are H. influenzae and S. pneumoniae as well as S. aureus. However, there are also several other substances and materials other than bacteria that can also be aspirated into the airway and pulmonary cavity such as gastric contents and foreign material (exogenous and endogenous). This type of aspiration pneumonia can result in inflammatory changes that can lead to bacterial growth which may impair the lung’s defenses leading to a full blown pneumonia infection.
Pathophysiology of aspiration pneumonia
The upper airway characteristics are genetically engineered to prevent potentially infectious particles from entering the lower respiratory tract which is considered to be sterile and free from foreign material that could otherwise result in aspiration pneumonia. Pneumonia normally occurs from normal flora (normal bacteria inhabiting in a specific region of the body that does not cause infection) present in an individual whose immune system becomes severely compromised or aspiration of a normal flora present in the upper airway tract which is not sterile in nature which upon entering the lower respiratory tract triggers the immune response. Moreover, pneumonia can also occur from blood borne microorganisms that enters the pulmonary blood circulation and becomes lodged within the capillary bed which in turn activate the immune response as well.
Risk factors of aspiration pneumonia
Aspiration pneumonia is highly preventable with the right information and the right knowledge regarding the predisposing risk factors and possible aggravating circumstances that commonly influence people in acquiring pneumonia. By knowing the potential individuals at high risk of becoming infected, preventive measures can be enforced to such individuals to better protect themselves from acquiring such disease condition. The growing numbers of individuals who have low immunity against infections such as those infected with HIV-AIDS, individuals undergoing chemotherapy, the very young and very old are generally the ones with a high risk of becoming infected as compared with healthy adults.
Clinical manifestations and medical management of aspiration pneumonia
Pneumonia greatly varies in its clinical signs and symptoms that are generally dependent on the causative microorganism, current health status as well as any preexisting disease condition of an individual. Individuals generally exhibit upper respiratory tract infection which includes nasal congestion, and sore throat. Predominant symptoms of the early stages of the disease are low-grade fever, headache and pleuritic pain. After a few days of non-treatment, additional
symptoms such as purulent mucus which later results in hypoxia due to poor oxygenation and gas exchange.
The treatment of pneumonia involves the administration of the appropriate antibiotic agents as determined by the results of bacterial culture and sensitivity. However, community acquire pneumonia cases which most of the time does not have an identifiable etiologic agent, an empirical therapy must be instituted which includes prescription of a broad range antibiotic agents as well as control of the accompanying clinical symptoms of aspiration pneumonia.