Intensive Care Medicine (ICM) Practice Exam

In a case of aspiration pneumonia, what is the most likely cause of the lung infection?

1. Aspiration of saliva

2. Aspiration of vomit

3. Aspiration of food

4. Aspiration of liquid

The correct answer is: Aspiration of vomit

In the context of aspiration pneumonia, the most likely cause of lung infection is the aspiration of vomit. This type of aspiration typically introduces a mix of gastric contents, which often include acidic substances, as well as a complex array of bacteria. When vomit is aspirated, it can introduce pathogens from the gastrointestinal tract into the lungs, creating an environment conducive to infection. The acidic nature of gastric contents can lead to chemical irritation in the lung tissue, contributing to inflammation and subsequent infection. Moreover, the presence of anaerobic bacteria from the oropharynx that are often present in vomit can further predispose patients to infection. Common pathogens associated with aspiration of vomit include various members of the normal flora of the mouth and gastrointestinal tract, such as Streptococcus, Staphylococcus, E. coli, and anaerobes. While saliva, food, and liquid aspirations can also lead to lung infections, they are generally less likely to cause the severe infections typically seen with aspiration of vomit, primarily due to the composition and the presence of more virulent bacteria in gastric contents. Understanding these dynamics is crucial for effective management and treatment of aspiration pneumonia.