Remarks The anatomic distinction between lobar pneumonia and bronchopneumonia is blurry: Many organisms present with either of the two patterns of distribution Confluent bronchopneumonia can be hard to distinguish radiologically from lobar pneumonia 2. The onset is usually abrupt, with high fever, shaking chills pleuritic chest pain, and a productive mucopurulent cough. 16
16 Remarks 1. The anatomic distinction between lobar pneumonia and bronchopneumonia is blurry: Many organisms present with either of the two patterns of distribution. Confluent bronchopneumonia can be hard to distinguish radiologically from lobar pneumonia. 2. The onset is usually abrupt, with high fever, shaking chills, pleuritic chest pain, and a productive mucopurulent cough
A Lobar pneumonia Conception Contiguous airspaces of part or all of a lobe are homogeneously filled with an exudate that can be visualized on radiographs as a lobar or segmental consolidation - a disease of acute exudative inflammation
17 A. Lobar pneumonia Conception Contiguous airspaces of part or all of a lobe are homogeneously filled with an exudate that can be visualized on radiographs as a lobar or segmental consolidation. — A disease of acute exudative inflammation
Pathogenesis Healthy adults Host defenses depressed Heavy contamination by virulent pathogens Normal inhabitants of the oropharynx and nasopharynx Pneumococcus(95%)
18 Pathogenesis — Healthy adults — Host defenses depressed — Heavy contamination by virulent pathogens — Normal inhabitants of the oropharynx and nasopharynx Pneumococcus (95%)
Pathology and clinical features A rather clear cut 4 staged battle in the affected lung in a period about 7-8 days =k A complete and unsloppy recovery Four stages: Congestion Red hepatization Gray hepatization Resolution 19
19 Pathology and clinical features A rather clear cut 4 staged battle in the affected lung in a period about 7~8 days A complete and unsloppy recovery Four stages: Congestion Red hepatization Gray hepatization Resolution
I Congestion (1N2d) Gross - Heavy, red, boggy LM- Vascular congestion Proteinaceous fluid containing numerous pneumococci filling the alveoli Scattered neutrophils
20 I Congestion (1~2d) Gross — Heavy, red, boggy LM — Vascular congestion — Proteinaceous fluid containing numerous pneumococci filling the alveoli — Scattered neutrophils