Analysis of the etiology and clinical features of exogenous aspiration pneumonia in children

Objective: Analyze the etiology and clinical features of exogenous aspiration pneumonia in children to provide reference for clinical diagnosis and treatment.

Methods: A retrospective analysis was conducted on the clinical data of 88 children with exogenous aspiration pneumonia admitted to the Children's Hospital Affiliated to Shandong University from January 2020 to May 2025. The patients were divided into liquid group (68 cases), solid group (14 cases), and gas group (6 cases) based on the physical form of the aspirated foreign material. The etiology and clinical characteristics of the three groups were analyzed and compared.

Results: Among the 88 pediatric cases, the ages ranged from 4 months and 17 days to 13 years, with a median age of 33 months. Nine cases had underlying diseases. The liquid group accounted for the highest proportion at 77.3%. No statistically significant differences were observed in respiratory, neurological, or digestive system symptoms among the three groups (P?0.05). Chest imaging revealed bilateral lung involvement in 92.0% of the cases. Pathological examinations were completed for 87 cases, identifying 8 strains of fungi and 86 strains of bacteria, including 36 strains of Gram-positive bacteria and 50 strains of Gram-negative bacteria. No statistically significant difference was found in the detection rate of Gram-positive bacteria among the three groups (P?0.05). The detection rate of Gram-negative bacteria in the liquid group was higher than that in the solid group (P?0.0167). Within the liquid group, no statistically significant differences were observed in the detection rates of Gram-positive or Gram-negative bacteria among the drowning, organic solvent, and fecal aspiration subgroups (P?0.05). Seventy-six cases were cured or improved and discharged, while 12 cases had poor prognoses.

Conclusions: The highest incidence of aspiration occurs in children aged 1~3 years, with liquid aspiration being the primary cause, often affecting both lungs. Aspiration pneumonia (AP) is prone to secondary infections. Gram-negative bacteria are predominant in liquid aspiration (particularly fecal contamination), while Gram-positive bacteria are more common in cases of solid foreign body aspiration or drowning. Patients with liquid aspiration (especially fecal contamination) have the poorest prognosis. Clinical outcomes are closely associated with the stability of respiratory and circulatory functions, level of consciousness, and underlying metabolic diseases.

Yang Shuchun, female, graduated with a bachelor's degree from Shandong University. She has been working at Jinan Children's Hospital since 2013 and is currently a chief physician. She has been engaged in pediatric internal medicine clinical work for over 10 years and has accumulated rich clinical experience. She is proficient in treating children's severe and infectious diseases. She is the principal researcher of one project under the Science and Technology Plan of Jinan Health Commission and has participated in the publication of several papers.