Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • intractable cough
  • fever
  • dyspnea
  • wheezing
  • crackles

Risk factors

  • decreased level of consciousness (Glasgow coma scale score <9)
  • increased severity of illness
  • general anesthesia
  • age >70 years
  • male gender
  • head trauma
  • cerebrovascular disease
  • endotracheal or tracheostomy tube
  • dysphagia
  • airway difficulties
  • barium meal
  • GERD
  • feeding tubes
  • supine position
  • delayed gastric emptying
  • obesity
  • drugs that reduce esophageal sphincter tone

Diagnostic investigations

Investigations to consider

  • chest CT
  • bronchoscopy with bronchoalveolar lavage
  • CBC
  • arterial blood gases
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Volunteer Clinical Faculty

Division of Pulmonary Sciences and Critical Care Medicine

University of Colorado Denver

Aurora

CO

Disclosures

MM declares that he has no competing interests.

Dr Madison Macht would like to gratefully acknowledge Dr Kamran Mahmood, Dr Scott Shofer, Dr Septimiu Murgu, and Dr Henri Colt, previous contributors to this monograph. KM, SS, SM, and HC declare that they have no competing interests.

Peer reviewers VIEW ALL

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

Director

Interventional Pulmonology

Division of Pulmonary, Allergy, and Critical Care Medicine

Assistant Professor of Medicine

Duke University Medical Center

Durham

NC

Disclosures

MMW declares that he has no competing interests.

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