Aspiration pneumonia is a common disease in the world. Clinician may frequently diagnose this disease by clinical symptoms, radiological findings, and lab data. But, I don't know the standard criteria of diagnosing aspiration pneumonia. Does anybody know an international criteria of this common disease ?
I fear that there are no standard criteria for diagnosing aspiration pneumonia. I recommend the follwing paper which discusses the disease in very instructive way:
http://www.sciencedirect.com/science/article/pii/S0883944114002871
I think there are no internationally accepted guidelines for diagnosis of aspiration pneumonia, but you may follow this paper:
1. https://www.mja.com.au/system/files/issues/195_07_031011/kwo10298_fm.pdf
2. http://www.fidssa.co.za/Content/Documents/cap2007.pdf (included in CAP management)
3. https://www.brit-thoracic.org.uk/document-library/clinical-information/pneumonia/adult-pneumonia/bts-guidelines-for-the-management-of-community-acquired-pneumonia-in-adults-2009-update/ (included in CAP management)
4. http://www.uptodate.com/contents/aspiration-pneumonia-in-adults
This is a great question. Even pneumonia (PNA) is hard to agree on as a diagnosis now that we can CT the chest so easily and with so little radiation. I think PNA should be looked upon a little like the adage we give our children about words like "stupid" or "ugly". They are each as they do; that is to say "ugly is as ugly does" or "stupid is as stupid does". PNA is as an infection does, not just as an infiltrate exits or as sputum becomes purulent. The infiltrate may actually be endobronchial secretions on CT and the purulence may be bronchitis rather than PNA. Aspiration PNA is in my practice a pairing of known aspiration tendency and USUALLY a micro bacterial sample that has more than one oral organism at a higher colony count than background. The problem is that chronic aspiration PNA typically starts selecting organisms that are more apt to prevail against others such as staph and particularly MRSA that often is sensitive to bactrim or ciprofloxicin. Also, acute on chronic infections add to the complexity of this care. And lastly, chronic aspiration, if it survived long enough, stops being an infectious process and becomes one that is a source of inanition and cachexia. The host relegates more and more of their nutrition to fighting the chronic airway soilage that they lose reserve and eventually succumb to an infection sometimes years later that results in sepsis and death. This is more common in the post radiation dysfunction of the laryngopharynx rather than in post CVA aspiration, though I have seen this in both.
I guess there are no internationally accepted guidelines for diagnosis or treatment of aspiration pneumonia but I invite you to visit: Agency for Healthcare Research and Quality: Advancing Excellence in Health Care at: http://qualitymeasures.ahrq.gov/
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