Hypoxaemia and respiratory acidosis. Alveolar-arterial O2 gradient correlates with severity of pneumonitis. Antibiotic selection is empiric in the first instance but may subsequently be modified on the basis of culture results. 1g intravenously daily. Corticosteroids are of no benefit and may be detrimental.
Most patients improve rapidly.
The chest x-ray infiltrates usually resolve within two weeks. Clinical deterioration occurring at about 48 hours following the aspiration indicates likely bacterial superinfection. This deterioration is marked by recurrent fever, leucocytosis, development of purulent sputum and a new or extending pulmonary infiltrate on x-ray. Lindsay Murray, Queen Elizabeth II Medical Centre, Perth, Australia. C.P. Snook, J. Szajewski.