Two aspiration syndromes have been identified: Aspiration pneumonia is infectious
caused by micro-aspiration of oral bacteria secondary to neurogenic dysphagia or sedation.
Infectious bacteria may also be aspirated from the stomach. Aspiration pneumonitis
classically follows large bolus aspiration of food, acid, or digestive enzymes and
is initially noninfectious. Large bolus gastric aspiration events may have an acute/dramatic
onset. This article discusses (1) prevention of recurrent aspiration events caused
by 2 common motility disorders: neurogenic dysphagia and gastro esophageal reflux;
(2) mechanical source control (debridement/drainage) of sites that may harbor large
collections of bacteria protected from antibiotics in biofilm including dental plaque,
coated tongue, and chronic sinusitis.
Keywords
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