Difference between revisions of "Pneumonia"

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Pneumonia (view source)

Revision as of 02:52, 13 February 2016

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→‎Acute infectious pneumonia: split out
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==Acute infectious pneumonia==
==Acute infectious pneumonia==
===General===
{{Main|Acute infectious pneumonia}}
*This is seen by pathologists, in [[autopsy]], from time-to-time.
 
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 + [[PMN]]s.<ref name=Ref_AoGP95>{{Ref AoGP|95}}</ref>
 
DDx:
*[[Aspiration pneumonia]] - aspirated material, usually lack microorganisms.
 
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==
Michael
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