RT Book, Section
A1 Enfield, Kyle B.
A1 Sifri, Costi D.
A2 Grippi, Michael A.
A2 Elias, Jack A.
A2 Fishman, Jay A.
A2 Kotloff, Robert M.
A2 Pack, Allan I.
A2 Senior, Robert M.
A2 Siegel, Mark D.
SR Print(0)
ID 1122369127
T1 Aspiration, Empyema, Lung Abscesses, and Anaerobic Infections
T2 Fishman's Pulmonary Diseases and Disorders, 5e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179672-9
LK accessmedicine.mhmedical.com/content.aspx?aid=1122369127
RD 2024/04/24
AB Aspiration  pneumonia,  lung  abscess,  and  necrotic  lung  are  parenchymal  lung  diseases.  Aspiration  pneumonia  refers  to  the  pulmonary  consequences  that  follow  abnormal  entry  of  fluid,  particulate  substances,  or  endogenous  secretions  from  the  upper  airways  or  gastric  contents  into  the  lower  airways  (see  also  Chapter  69).  To  develop  aspiration  pneumonia,  a  series  of  formidable  host  defense  mechanisms  that  normally  protect  the  lower  airways  must  be  overcome,  including  glottic  closure  via  the  cricopharyngeus  muscle,  the  cough  reflex,  ciliary  clearance,  and  other  defense  mechanisms.  The  material  aspirated  must  generate  an  inflammatory  response  or  cause  obstruction.  The  nature  of  the  pneumonia  that  develops  depends  on  the  inoculum  and  the  host  response.  Anaerobic  bacteria  are  the  most  common  pathogens  in  this  setting,  reflecting  both  pathogenic  potential  and  importance  in  the  normal  flora  of  the  upper  airways.  Risk  factors  for  aspiration  may  be  transient  (anesthesia,  intoxication)  or  persistent  (e.g.,  neuromuscular  disorders,  achalasia)  with  the  risk  for  recurrence  depending  on  recognition  and  resolution  of  the  inciting  defect.1,2