Difference between revisions of "Pneumonia"
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Revision as of 06:29, 28 December 2011
Pneumonia is inflammation of the lung.
There are various types of pneumonia.
Infectious pnemonia
Anatomical classification of pneumonia
- Generally, not used by clinicians.
- Use of the terms without qualification is discouraged... as they do not make explicit the etiology.
Bronchopneumonia
- Multiple foci of (acute) inflammation involving the bronchi.
- This is the most common form of (infectious) pneumonia.
Lobular pneumonia
- Pneumonia that involves a hole lobe.
- Rarely seen in areas where antibiotic treatments are widely available.
Acute infectious pneumonia
General
- This is seen by pathologists, in autopsy, from time-to-time.
Most common cause:
- Streptococcus pneumoniae.[1]
The top three community acquired (acute) pneumonia:[2]
- Streptococcuc pneumonia.
- Haemophilus influenzae.
- Moraxella catarrhalis.
Other community acquired pneumonia:[1]
- S. aureus.
- Legionaella pneumophila.
- Klebsiella pneumoniae.
- Pseudomonas.
Hospital-acquired pneumonia:[1]
- 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.
Microscopic
Features:
- Alveoli packed with PMNs.
- +/-Clusters of bacteria - small dots or rods.
Image: Normal alveoli & pneumonia (WC).
Stains
- Gram stain -- to type the bacteria.
Chronic infectious pneumonia
General
Common microorganisms:[1]
- Nocardia.
- Actinomyces.
- Mycobacterium tuberculosis.
- Atypical mycobacterium, e.g. Mycobacterium avium-intracellulare.
- Histoplasma capsulatum.
- Coccidioides immitis.
- Blastomyces dermatitidis.
Note:
- All of the later ones are granulomatous.
Microscopic
Features:
- Inflammation.
- +/-Granulomas.
Diffuse lung diseases
Main article: Diffuse lung disease
- AKA idiopathic interstitial pneumonia.
Histologic pattern:
- Organizing pneumonia.
- Usual interstitial pneumonia.
- Nonspecific interstitial pneumonia.
- Lymphocytic interstitial pneumonia.
- Desquamative interstitial pneumonia.
- Diffuse alveolar damage.
See also
References
- ↑ 1.0 1.1 1.2 1.3 Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 711. ISBN 978-1416031215.
- ↑ Nicolau, D. (Sep 2002). "Clinical and economic implications of antimicrobial resistance for the management of community-acquired respiratory tract infections.". J Antimicrob Chemother 50 Suppl S1: 61-70. PMID 12239229.