ABSTRACT

This chapter begins with the investigation, diagnosis, and management of aspiration pneumonia which is not rare and is seen in both hospital and community practice. Aspiration pneumonia is caused by organisms that are normal commensals of the oropharynx, or by gastrointestinal or environmental organisms that have replaced the normal flora of the oropharynx because of antibiotic therapy, intubation, or concurrent debilitating illness. Aspiration pneumonia may show a wide range of appearances depending on the nature of the aspirated material. Infection of intrathoracic structures is uncommon, and may result from aspiration, lymphatic extension from the oropharynx, or passage across. Coccidiomycosis is a chronic lung infection caused by inhalation of fungal spores. Most infections are mild or asymptomatic, the area of focal pneumonitis healing spontaneously to leave a coin-like scar or a single, small, thin-walled cavity. Coccidiomycosis mainly presents as focal or multifocal airspace disease predominantly in the lower lobes.