|
|
(14 intermediate revisions by the same user not shown) |
Line 1: |
Line 1: |
| | [[Image:Acute pneumonia - i -- low mag.jpg|thumb|Acute pneumonia. [[H&E stain]]. (WC)]] |
| '''Pneumonia''' is inflammation of the lung, which includes infectious and non-infectious etiologies. | | '''Pneumonia''' is inflammation of the lung, which includes infectious and non-infectious etiologies. |
|
| |
|
| It is a subset of the [[medical lung diseases]]. This article primarily deals with the infectious pneumonias. [[Idiopathic interstitial pneumonia]]s are discussed very briefly and dealt with in detail in the ''[[diffuse lung diseases]]'' article. | | It is a subset of the [[medical lung diseases]]. This article primarily deals with the infectious pneumonias. |
| | |
| | Idiopathic interstitial pneumonias are listed at the bottom; they are dealt with in detail in the ''[[diffuse lung diseases]]'' article. |
|
| |
|
| =Infectious pnemonia= | | =Infectious pnemonia= |
Line 21: |
Line 24: |
|
| |
|
| ==Acute infectious pneumonia== | | ==Acute infectious pneumonia== |
| ===General===
| | {{Main|Acute infectious pneumonia}} |
| *This is seen by pathologists, in [[autopsy]], from time-to-time.
| | The most common form of pneumonia. It is usually diagnosed clinically. |
| | |
| Most common cause:
| |
| *''Streptococcus pneumoniae''.<ref name=Ref_PBoD8_711>{{Ref PBoD8|711}}</ref>
| |
| | |
| The top three community acquired (acute) pneumonia:<ref name=pmid12239229>{{Cite journal | last1 = Nicolau | first1 = D. | title = Clinical and economic implications of antimicrobial resistance for the management of community-acquired respiratory tract infections. | journal = J Antimicrob Chemother | volume = 50 Suppl S1 | issue = | pages = 61-70 | month = Sep | year = 2002 | doi = | PMID = 12239229 }}</ref>
| |
| *''Streptococcuc pneumonia''.
| |
| *''Haemophilus influenzae''.
| |
| *''Moraxella catarrhalis''.
| |
| | |
| Other community acquired pneumonia:<ref name=Ref_PBoD8_711>{{Ref PBoD8|711}}</ref>
| |
| *S. aureus.
| |
| *Legionaella pneumophila.
| |
| *Klebsiella pneumoniae.
| |
| *Pseudomonas.
| |
| | |
| Hospital-acquired pneumonia:<ref name=Ref_PBoD8_711>{{Ref PBoD8|711}}</ref>
| |
| *Gram-negative rods.
| |
| *''Staphylococcus aureus''.
| |
| | |
| ===Radiologic correlate===
| |
| *Air space disease.
| |
| | |
| ===Gross pathology===
| |
| *Consolidation (the lung parenchyma is firm) - best appreciated by running a finger over the cut surface of the lung with a small-to-moderate amount of pressure.
| |
| | |
| Bronchopneumonia:
| |
| *Classically yellow-white centered on the bronchi.<ref>{{Ref AoGP|93}}</ref>
| |
| | |
| Lobar pneumnia is classically described in four stages:<ref>{{Ref AoGP|92}}</ref><ref>URL: [http://www.histopathology-india.net/Lobar_Pneumonia.htm http://www.histopathology-india.net/Lobar_Pneumonia.htm]. Accessed on: 27 February 2012.</ref>
| |
| #Congestion - day 1-2.
| |
| #Red hepatization - day 2-4.
| |
| #Gray hepatization - day 4-6.
| |
| #Resolution - day 6+.
| |
| | |
| Note:
| |
| *The stages of lobar pneumonia is considered more-or-less historical. In the age of antibiotics, lobar pneumonia is uncommon.
| |
| | |
| ===Microscopic===
| |
| Features:
| |
| *Alveoli packed with [[PMN]]s.
| |
| *+/-Clusters of bacteria - small dots or rods.
| |
| *+/-Abscess formation.
| |
| **Lung abscess = destruction of parenchyma + PMNs.<ref name=Ref_AoGP95>{{Ref AoGP|95}}</ref>
| |
| | |
| Image:
| |
| *[http://commons.wikimedia.org/wiki/File:Pneumonia_alveolus.jpg Normal alveoli & pneumonia (WC)].
| |
| | |
| ===Stains===
| |
| *Gram stain -- to type the bacteria.
| |
|
| |
|
| ==Chronic infectious pneumonia== | | ==Chronic infectious pneumonia== |
Line 91: |
Line 45: |
| *+/-[[Granuloma]]s. | | *+/-[[Granuloma]]s. |
| ==Aspiration pneumonia== | | ==Aspiration pneumonia== |
| ===General===
| | {{Main|Aspiration pneumonia}} |
| *Usually seen in the context of a toxin and/or pathology that affects the swallowing and cough reflexes.<ref name=pmid16082150>{{Cite journal | last1 = Ohrui | first1 = T. | title = Preventive strategies for aspiration pneumonia in elderly disabled persons. | journal = Tohoku J Exp Med | volume = 207 | issue = 1 | pages = 3-12 | month = Sep | year = 2005 | doi = | PMID = 16082150 }}</ref>
| |
| **[[Stroke]].
| |
| **[[Multiple sclerosis]].
| |
| **Alcohol.
| |
| | |
| *The microorganisms involved are usually different than in other causes of acute pneumonia.
| |
| | |
| ===Gross===
| |
| *More common in the right lung.
| |
| **Right main stem bronchus is more vertical.
| |
| | |
| ===Microscopic===
| |
| Features:
| |
| *+/-Foreign body giant cells.
| |
| *Microorganisms.
| |
| | |
| Images:
| |
| *[http://commons.wikimedia.org/wiki/File:Aspiration_pneumonia_%281%29.jpg Aspiration pneumonia - 1 - (WC)].
| |
| *[http://commons.wikimedia.org/wiki/File:Aspiration_pneumonia_%282%29.jpg Aspiration pneumonia - 2 - (WC)].
| |
| *[http://commons.wikimedia.org/wiki/File:Aspiration_pneumonia_%283%29.jpg Aspiration pneumonia - 3 - (WC)].
| |
|
| |
|
| ==Cytomegalovirus pneumonia== | | ==Cytomegalovirus pneumonia== |