The evaluation of someone with aspiration pneumonia begins with a history and physical examination.

Physical findings in those with aspiration pneumonia may include:

• Signs of severe difficulty breathing
• Rib retractions
• Nasal flaring
• Use of accessory muscles
• Cyanosis
• Dry mucous membranes and skin, or other signs of dehydration
• Fever
• Rapid pulse
• Rapid breathing
• Wet rales and rhonchi sounds in the chest
• Wheezing

Tests are necessary to confirm the diagnosis of aspiration pneumonia and determine its severity.

Testing for aspiration pneumonia may include:

• Complete blood count: helps assess the severity of infection
• Chest x-ray:
• Normal chest x-ray
• Chest x-ray showing pneumonia
• Pulse oximetry:
• May show low oxygen levels
• Blood cultures:
• Detects bacteria that have spread into the bloodstream
• Bronchoscopy:
• Can obtain sputum for bacterial cultures, clear the airway. or retrieve a foreign body
• Cultures of sputum (mucus) for bacteria and viruses
• Rapid influenza testing
• Urine antigen testing for pneumococcus or Legionella