Difference between revisions of "Pneumonia"

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*+/-[[Granuloma]]s.
*+/-[[Granuloma]]s.
==Aspiration pneumonia==
==Aspiration pneumonia==
===General===
{{Main|Aspiration pneumonia}}
*Not associated with microorganisms - though empiric antibiotics are relatively common to cover infectious pneumonias that cannot be excluded easily on clinical grounds.<ref name=pmid21263315>{{Cite journal  | last1 = Raghavendran | first1 = K. | last2 = Nemzek | first2 = J. | last3 = Napolitano | first3 = LM. | last4 = Knight | first4 = PR. | title = Aspiration-induced lung injury. | journal = Crit Care Med | volume = 39 | issue = 4 | pages = 818-26 | month = Apr | year = 2011 | doi = 10.1097/CCM.0b013e31820a856b | PMID = 21263315 }}</ref>
 
*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>
 
Common associations:<ref name=pmid16082150/>
*[[Stroke]].
*[[Multiple sclerosis]].
*[[Alcohol]] intoxication.
 
Other risk factors:<ref name=pmid21263315/>
*Traumatic brain injury.
*Seizure disorder.
*Bowel obstruction.
*Drugs.
*[[Obesity]].
*Labour.
 
Note:
*A special type of aspiration pneumonia is ''lipoid pneumonia''. It is dealt with in the ''[[lipoid pneumonia]]'' article.
 
===Gross===
*More common in the right lung.
**Right main stem bronchus is more vertical.
 
===Microscopic===
Features:
*Neutrophils.
*Foreign material, e.g. plant matter.
*+/-Foreign body giant cells.
*+/-Microorganisms.
 
DDx:
*[[Acute infectious pneumonia]].
 
====Images====
<gallery>
Image:Aspiration_pneumonia_%281%29.jpg | Aspiration pneumonia - 1 - (WC)
Image:Aspiration_pneumonia_%282%29.jpg | Aspiration pneumonia - 2 - (WC)
Image:Aspiration_pneumonia_%283%29.jpg | Aspiration pneumonia - 3 - (WC)
</gallery>


==Cytomegalovirus pneumonia==
==Cytomegalovirus pneumonia==

Latest revision as of 15:26, 5 March 2017

Acute pneumonia. H&E stain. (WC)

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 pneumonias are listed at the bottom; they are dealt with in detail in the diffuse lung diseases article.

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.

Lobar pneumonia

  • Pneumonia that involves a whole lobe.
  • Rarely seen in areas where antibiotic treatments are widely available.

Acute infectious pneumonia

Main article: Acute infectious pneumonia

The most common form of pneumonia. It is usually diagnosed clinically.

Chronic infectious pneumonia

General

Common microorganisms:[1]

Note:

  • All of the later ones are granulomatous.

Microscopic

Features:

Aspiration pneumonia

Main article: Aspiration pneumonia

Cytomegalovirus pneumonia

Main article: Cytomegalovirus

General

  • Immunodeficiency.
  • Critical illness.[2]

Microscopic

Features:

  • CMV nuclear changes:
    • Large red nucleus with a pale halo.
  • Eosinophilic granular cytoplasmic inclusions.

Images:

IHC

  • CMV +ve -- cytoplasmic inclusions, large nucleus.

Diffuse lung diseases

Main article: Diffuse lung disease
  • AKA idiopathic interstitial pneumonia.

Histologic pattern:

See also

References

  1. ↑ 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.
  2. ↑ Limaye, AP.; Boeckh, M. (Nov 2010). "CMV in critically ill patients: pathogen or bystander?". Rev Med Virol 20 (6): 372-9. doi:10.1002/rmv.664. PMID 20931610.
  3. ↑ URL: http://www.pathologyoutlines.com/topic/lungnontumorCMV.html. Accessed on: 23 January 2012.
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