* Def: acute diffuse fibrinous inflammation of one or more lung
lobes. * Etiology: Age: middle age. Predisposing factors: low
resistance. Causative organism: pneumococci. Route of infection:
droplet infection.
Slide 6
* Pathogenesis: Pneumococci are inhaled to reach alveoli. They
cause acute inflammaion with excess fluid exudate. This fluid
exudate pass from one alveolus to another rapidly through the
inter- alveolar pores of cohn to involve the whole lung lobe. The
fluid exudate expel air away from the alveoli producing a firm
airless lobe leading to consolidation (hepatisation) of the
affected lobe.
Slide 7
4. Stage of resolution 3. Stage of gray hepatization 2. Stage
of red hepatization 1. Stage of congestion 1. Duration 9th day
215th 8th day2nd 4th day1st day 2. Gross Picture: the affected lobe
is - Since there is no necrosis, healing by resolution occurs. -
Enlarghed. - Gray. - Consistency: consolidated (hepatized). - Cut
section: dry. - Pleurisy. - Enlarged hilar LNs. - Enlarged. - Red.
- Consistency: consolidated (hepatized). - Cut section: dry. -
Pleurisy. - Enlarged hilar LNs. - Size: Enlarged. - Color: Red. -
Consistency: like wet sponge. - Cut section: exudes frothy fluid. -
The covering pleura: normal - The hilar L.Ns.: normal
Slide 8
Lobar pneumonia of upper lobe
Slide 9
Lobar pneumonia of the lower lobe
Slide 10
4. Stage of resolution 3. Stage of gray hepatization 2. Stage
of red hepatization 1. Stage of congestion 3. Microscopic Picture
a. Alveolar capillaries: Less congested b. Alveolar walls: thin. c.
Alveolar spaces: Show dead bacteria, shrinked fibrin, hemolysed
RBCs, excess polymorphs and macrophages. a. Alveolar capillaries:
Congested. b. Alveolar walls: thickened. c. Alveolar spaces: Show
bacteria, fibrin, RBCs and polymorphs. a. Alveolar capillaries:
Congested. b. Alveolar walls: thickened. c. Alveolar spaces: Show
bacteria & fluid exudate.
Slide 11
Lobar pneumonia; red hepatization
Slide 12
Lobar pneumonia; grey hepatization
Slide 13
4. Stage of resolution 3. Stage of gray hepatization 2. Stage
of red hepatization 1. Stage of congestion 4. Clinical course -
Fever, cough, dyspnea and chest pain. - At about 9th day the
disease ends by crisis (sudden improvement), however death may
occur due to severe toxaemia.
Slide 14
4. Stage of resolution 3. Stage of gray hepatization 2. Stage
of red hepatization 1. Stage of congestion 5. Complications 1.
Spread of infection: direct, lymphatic and blood (toxaemia,
septicaemia). 2. Lung fibrosis due to failure of resolution. 3.
Post-pneumonic lung abscess.
Slide 15
BRONCHOPNEUMONIA
Slide 16
* Def: Acute suppurative inflammation of bronchioles and
adjacent alveoli characterized by patchy lung consolidation. *
Etilogy: Age: extremes of age (young & elderly). Predisposing
factors: low resistance and bronchitis. Causative bacteria:
staphylococci, streptococci & H. influenza. Route of infection:
endogenous invaders and exogenous invaders (droplet
infection).
Slide 17
* Gross picture: Bilateral. Basal. Multiple consolidated
yellowish patches exuding pus on pressure. Several patches may
coalesce to produce confluent bronchopneuomonia. Enlarged hilar L.
nodes.
Slide 18
Bronchopneumonia
Slide 19
Bronchopneumonia
Slide 20
* Microscopic Picture: I. The broncioles show: Their lumen
shows: necrotic epithelial cells, polymorphs & pus cells. Their
lining: ulceration. Their walls: congested capillaries, neutrophils
and pus cells & exudate. II. The adjacent alveoli show: 3
successive zones: zone of alveolitis then zone of alveolar collapse
and a zone of alveolar dilatation (compensatory emphysema).
Slide 21
Slide 22
* Complications: 1. Spread of infection: direct, lymphatic and
blood (toxaemia, septicaemia). 2. Lung fibrosis due to failure of
resolution. 3. Post-pneumonic lung abscess. 4. Bronchiectasis.
