Aspiration pneumonia can occur if a person breathes something into their lungs instead of swallowing it. Germs, food particles, saliva, vomit, or other substances may infect the airways. Treatment often involves the use of oxygen and antibiotics.

Aspiration pneumonia is less common in healthy individuals and more common in people with existing health complications. It is different from regular pneumonia, which refers specifically to an infection by a virus, bacteria, or fungus that infects the person as a whole and then spreads to the lungs.

Aspiration pneumonia begins as a type of pneumonitis, which is a general term for lung inflammation. Pneumonitis can also occur from environmental triggers such as exposure to chemicals. Any person can get pneumonitis regardless of the state of their health. This results in inflammation that occurs that allows bacteria to grow in the lungs, causing pneumonia.

This article reviews the symptoms, causes, risk factors, diagnosis, and treatment of aspiration pneumonia.

A female lying on a bed sneezing into a napkin,Share on Pinterest
Guido Mieth/Getty Images

Viruses and bacteria can cause pneumonia, which is an infection that can lead to inflammation of the lungs and airways.

In aspiration pneumonia, a person accidentally breathes a substance into their lungs instead of swallowing it. The substance, such as food, saliva, vomit, or medication, brings in bacteria, which can cause the infection.

Healthy lungs can usually handle the bacteria from these types of accidents and get rid of as much of it as possible through a cough.

People who have trouble coughing, are less alert, are already ill, or those with compromised immune systems are more prone to aspiration pneumonia.

About 18% of all aspiration pneumonia cases occur in nursing homes. It also accounts for about 5-15% of all community-acquired pneumonia cases. However, true numbers of the condition are difficult to determine due to the lack of biological markers that can help with diagnosis and the existence of asymptomatic cases.

Aspiration pneumonia can cause a range of symptoms, including:

  • shortness of breath or difficulty breathing
  • fatigue
  • chest pain
  • wheezing
  • slightly blue skin
  • high fever
  • sweating

Anyone with these symptoms should contact their doctor immediately for diagnosis and treatment.

Signs such as colored phlegm and high fever in children or older adults justify a trip to urgent care or the emergency room.

It is possible to die from aspiration pneumonia, so doctors will address the condition as soon as possible. An estimated 11-30% of people die from aspiration pneumonia.

Doctors will give special consideration to each person’s treatment to ensure they receive the correct antibiotic.

Life threatening complications might occur if the person has gone too long without treatment or has a compromised immune system.

The underlying cause of any case of aspiration pneumonia is breathing or sucking in a foreign substance, like food, drink, medication, or others, into the lungs. The substance causes bacterial growth, leading to a non-contagious infection.

Depending on many factors, the type of germs infecting the lungs or large airways may also change, but they are usually Streptococcus pneumonia, Staphylococcus aureus, or gram-negative infectious bacteria.

Aspiration pneumonia most frequently occurs in people with dysphagia, a swallowing disorder.

Several conditions are associated with dysphagia and increase a person’s risk of developing aspiration pneumonia. They include:

  • esophageal disorders or dysfunction
  • use of muscle relaxers, sedatives, or anesthesia
  • dental problems
  • problems with the nerves (neurological disorders)
  • throat cancer
  • stroke
  • seizure
  • heart attack
  • coma or other states of impaired consciousness
  • gastrointestinal reflux disease (GERD) or heartburn
  • disorders that impair the mental state, such as dementia

Other risk factors include:

  • advanced age
  • substance use disorder
  • poor gag reflexes

Doctors will work to diagnose and treat aspiration pneumonia as fast as possible. Doctors will typically ask about symptoms and then do a physical exam to check for signs of pneumonia.

Signs could include a crackling noise in the lungs while the person is breathing or a person is having difficulty breathing.

X-rays or computed tomography (CT) scans can provide images of the lungs. Doctors may also use a bronchoscope to look at the airways and check for any blockages.

A sputum culture test, complete blood count (CBC), or arterial blood gas test can help gauge how severe the infection is and what type of treatment is required.

They may also order an esophagram/barium swallow, which involves special x-rays with dye of the esophagus or a pharyngeal manometry to measure the pressure in the esophagus.

Treatment for aspiration pneumonia will vary depending on the person’s overall health and the severity of their symptoms. Doctors will also modify treatment for people allergic to or who have a reaction to penicillin.

Antibiotics are commonly used to help clear out the infection and avoid serious complications. Doctors typically start antibiotics if they believe a person’s pneumonitis is actually pneumonia. They may also recommend raising the bed to a 45-degree angle and providing humidified oxygen.

Some people may need to be hospitalized for long periods of time and with monitors checking their blood oxygen levels. If a person is having difficulty breathing, they may need to use a breathing machine.

If the person is having difficulty swallowing, doctors may recommend an assisted feeding method or a change of eating habits to avoid further aspiration.

Aspiration pneumonia can cause severe complications, especially if a person waits too long to go to the doctor.

The infection may progress quickly and spread to other areas of the body. It may also spread to the bloodstream, which is especially dangerous.

Pockets or abscesses may form in the lungs. In some cases, pneumonia can cause respiratory failure or death.

Diseases that affect swallowing or cause further inflammation may make aspiration pneumonia worse or prevent it from healing properly.

Some severe infections may result in long-term damage and scarring in the lungs and major airways.

Aspiration pneumonia is not always preventable, but some lifestyle choices can help reduce the risk.

Misusing alcohol or other substances raises the risk of aspiration pneumonia, as a person may be too intoxicated to swallow properly.

Prescription medications that affect the muscles or make a person overly drowsy can also increase the risk of aspiration pneumonia.

Anyone who feels that their food regularly goes down the wrong pipe when they are taking prescription medications should talk with their doctor about adjusting the dosage or switching medications to avoid breathing in foreign particles.

Other tips to help prevent aspiration pneumonia include:

  • practicing good dental and oral hygiene
  • not smoking
  • sitting up while eating and chewing slowly and deliberately
  • eating slowly
  • avoiding laughing or talking while eating
  • seek counseling for alcohol or substance misuse
  • avoid foods that are difficult to swallow

In addition, being under general anesthesia raises the risk of getting gastric aspiration pneumonia, which is when a person inhales their own stomach acid.

For this reason, anyone about to undergo surgery should fast before the procedure for at least 8 hours. The doctor will usually provide specific guidelines for fasting in each case/

The outlook for people with aspiration pneumonia depends on several factors, such as how soon the person went to the doctor with their symptoms, how far the symptoms progressed, and their general health before getting pneumonia.

The type of object inhaled and the strain of bacterial infection may also play a role in a person’s recovery.

Most people survive aspiration pneumonia, though an estimated 11-30% of people pass away. Full recovery can take some time.

Doctors will monitor older individuals or those with compromised immune systems to avoid life threatening complications.

A person should follow a doctor’s treatment plan to give the body the best chance of recovery. Unless otherwise told by a doctor, a person should always complete a full course of antibiotic treatment, even if symptoms go away early on in the treatment.

Lifestyle changes, such as improving oral hygiene, eating slowly, avoiding certain foods, and quitting drugs or alcohol, may also help prevent aspiration pneumonia.

The following sections help answer frequently asked questions about aspiration pneumonia.

What are the first signs of aspiration pneumonia?

Aspiration pneumonia shows symptoms similar to pneumonia in many cases. Though symptoms can vary for different people, some people may experience difficulty swallowing, clearing their throat after eating and having a feeling of something stuck in the throat.

How long can you survive aspiration pneumonia?

Some evidence suggests that the 30-day survival rate is about 21%. However, since the condition may occur silently and go unreported, this estimate may not be accurate. Estimated death rates are between 11-30%, and those who do survive have a high chance of long-term complications and a long time until recovery.

How long does it take for aspiration to turn into pneumonia?

It can take a few days for aspiration to turn into pneumonia.

Can aspiration pneumonia clear itself?

A person will usually need about a week of antibiotic treatment with treatment. It can take between 1-4 weeks to recover and possibly longer based on a person’s age and other health complications. If the pneumonia is so severe that a person is hospitalized and has difficulty breathing, a longer course of antibiotics may be required.

Aspiration pneumonia occurs due to inhaling or sucking a substance into the airways or lungs. The substance gets stuck and causes a person to develop a bacterial infection.

In most cases, the illness affects older adults, people with trouble swallowing, and people with weakened immune systems.

When treated early, most people can recover. However, it is a dangerous infection, and people should seek medical care if they develop symptoms.