EE 2/8/2017 Pneumonia [At the end ofthe lecture the student should be able to 1) define pneurnonia 2) scuss the pathogenass of peumonia 3)elasty prevmanias 4}.dscussLobar peumonia—) aetiology l morphology 5) lscuss Broncho pneumonis..| complications soctor with + fever with hills + cough with purulent sputum + chest palo on beeathing or coughing + shortness of breath ‘of 3 days duration ‘AS2 year old previously healthy male presented to his On examination he was febsile ‘dullness on percussion Inthe area of the let lower lobe ‘reduced air entry in same area + He was admitted to hospital. + Investigations were done. + The patient was diagnosed as having a lett lower lobar pneumonia. What s Pneumonia? Pneumonia can be broadly defined as infection and Inflammation ofthe lung tissue.2/8/2017 What defence mechanism does the body have ro prevent respiratory tract infection? Whats pneumonitis ? tocal mechanisms ~ mucus ci, cough reflex, alveolar macrophages Generated mechanisms - Immunity ‘of pathogens into the re : Pathogenesis of pneumonia sry of path 1 the respiratory tact Decrease in general Impairment of clearing iki tan chaos resistance of host smechanisins 1 fans 11 Chronic aseases 1) Mucus ns within thet Hirenee denceoey aol IMatplcation of organisms within the lungs 3)Immunosuppression 3)AWeoar phagocytes | 4) Severe infections Si hlaloead asia Inflammatory reaction of the lung tisue : Pneumonia ‘lsscation according tothe anatomical pattern (Cassifieation of Pneumonia a may be classified according to several criteria in ebae Pneumonia Consoldation of alate 1) Anatomical Pattern + Lebar prewmonia + BronchopneumoniaPO Reet Ae 2/8/2017 + Affects a large part or the entirety of lobe +The lower lobes or the right middie lobe are most frequently nvoWved + Alfects males more than females + Relatively uncommen in intancy & old age Actiology Patholony 90% Streptococcus pneumoniae There are 4 stages ofan acute lobor other Staphylococcus preumonia klebsiella 1) Acute congestion Pseudomonas 2} Rea hepatisation Proteus 3) Gry hepatisation 4) Resolution Acute congestion Lasts for about 24nes +The bacteria are actively multiplying and spreading in the lng. + Dilatation ofthe septal cpilaries & lid exudation into the lung +The lung is heavy oedematous & red2/8/2017 Congestion Hepatization 4 ‘The Lung gros apes iar fos tne + Comtinved exucation of fluid + Neutrophil emigration into alveoli + Many red cells extravagated from listended caplaries into alveol + tung ised sot & ates Lobar pneumonia affecting the whole of the loner left lung. This solid and dull red (red hepatization) {due to inflammatory cenudate filing abeol ‘and small bronchi ‘Grey Hepatization + Fibvinous exdate within the alveol [With destruction of RBC & WBC in aol + Lung is Grey brown & solids Sse SSS ——ee ee 2/8/2017 Grey hepatization Grey Hepateation Resolution Resorption of alveolar exudate & ‘entymatic digestion of iflammatory cells with preservation of alveolar architecture 4 Lung Returns to Normal Somplicavons + Punts ibeinous 0 firno portent) a Morousthickening/permenant adhesions + Pew effsion + Resoratoy Faure (both ngs gros ioe) + empyema + Menwgia 4) + enor * Une dbcee th ree Game Tine Freund Bronchopneumonia . + Bronchopaeumonia is mainly seen at the extemes of age ‘e-nfants 8 elderly + Als seen inpatients with debbitating disease and post op due to fallure to clear respiratory secretions. + Mainly bilateral and basal2/8/2017 Aatlolony Patholony + Low virulence pathogens that would aot ‘cause disease n healthy Indiduals + Inflammation of # bronchiole or bronchus with spread to + Most cases ~ mixed bacterial Fora ‘the surrounding alveoli + strep pneumoniae prasant in 80% + Other streptococci * Lesions appear erey-ed to yellow & slightly elevated + stapmyococes + Haemophilus influenzae + The immediately surrounding lung is hyperemic & + Colors oedematous + Fung Bronchopneumonia + There are intervening areas of normal lung tissue + One or several lobes may be involved, most frequently bilateral and basal + Pleural involvement i less common than in lobar pneumonia Somplications + Multiple hing abscesses + Sacteraemia aap meningts, endocarditis + High mortaiey Inflammatory exudate surrounding a bronchioleHome work 1) wat otner citer can prewronia cin be clad acca 0? 2) wat is atypleal pneumonia ? What are is features? 2/8/2017