What are the signs of aspiration pneumonia?

Aspiration pneumonia is a lung infection that can develop when food, drink, saliva, stomach contents, or vomit enters the lower airways instead of the swallowing tube. Coughing during meals, a wet or gurgly voice, repeated choking, or difficulty swallowing can be clues that material has gone the wrong way. Later symptoms may include fever, chills, worsening cough, fast or difficult breathing, chest pain when breathing deeply, weakness, and yellow or green phlegm. Symptoms can be subtle in older adults or people with swallowing, neurological, or reduced-alertness problems.

Contact a clinician promptly if these symptoms follow choking, vomiting, sedation, a swallowing problem, or a reduced level of alertness. Keep the person sitting upright if they are awake and able to sit safely. Do not offer food or drink if swallowing is unsafe. A clinician may check oxygen levels, listen to the lungs, and arrange imaging or swallowing assessment. Treatment depends on examination findings and may include antibiotics, oxygen, fluids, or support for the underlying swallowing problem.

Call emergency services for severe breathlessness, blue or grey lips, confusion, fainting, inability to speak normally, or rapidly worsening weakness. Urgent assessment is also needed for persistent fever, chest pain, or a cough that follows a choking episode. Pneumonia can worsen and may lead to sepsis, so do not wait for symptoms to become extreme when breathing or alertness is changing.

Ask what may have entered the airway, whether swallowing should be assessed, which foods or textures are safer, and how to reduce aspiration risk during meals. Discuss medication effects, reflux, and steps to take if choking happens again.