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On examination, focal or diffuse crackles and wheezing are common. Cyanosis
may appear with more severe disease. CXRs ( Fig. 99.1 ) may show either
localized or diffuse infiltrates, which may be unilateral or bilateral. The CXR of a
patient who has aspirated may evolve from normal to complete bilateral
opacification within several hours. It can be difficult to distinguish aspiration
pneumonitis from pneumonia earlier in the clinical course.