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Pathology of Pneumonia Dr. Venkatesh M. Shashidhar Senior Lecturer in Pathology Fiji School of Medicine

Introduction: Daily 10,000 liters of air - filtered..! Pneumonia : Inflammation of lung. Respiratory tract infections – commonest in medical practice. Enormous morbidity & mortality.

Daily 10,000 liters of air - filtered..!

Pneumonia : Inflammation of lung.

Respiratory tract infections – commonest in medical practice.

Enormous morbidity & mortality.

Etiology: Decreased resistance - General/immune Virulent infection - Lobar pneumonia Clearing mechanism Cough Reflex Mucosal Injury Low Alveolar defense Pulmonary edema Obstructions

Decreased resistance - General/immune

Virulent infection - Lobar pneumonia

Clearing mechanism

Cough Reflex

Mucosal Injury

Low Alveolar defense

Pulmonary edema

Obstructions

Types: Viral Bacterial Mycoplasmal Fungal

Viral

Bacterial

Mycoplasmal

Fungal

Patterns of Pulmonary infections: Airway - Bronchitis, Bronchiectasis Parenchyma Pneumonia Bronchopneumonia Lobar pneumonia Lung abscess Tuberculosis

Airway - Bronchitis, Bronchiectasis

Parenchyma

Pneumonia

Bronchopneumonia

Lobar pneumonia

Lung abscess

Tuberculosis

Bronchopneumonia Staph, Strep, Pneumo & H. influenza Patchy consolidation – not limited to lobes. Suppurative inflammation Usually bilateral Lower lobes common Complications: Abscess Empyema Dissemination

Staph, Strep, Pneumo & H. influenza

Patchy consolidation – not limited to lobes.

Suppurative inflammation

Usually bilateral

Lower lobes common

Complications:

Abscess

Empyema

Dissemination

Broncho-pneumonia

Broncho-pneumonia

Broncho-pneumonia

Bronchopneumonia - Abscess formation

Bronchopneumonia:

Bronchopneumonia:

Bronchopneumonia - Abscess formation

Lung RSV Pneumonia:

Bronchopneumonia - CT

Bronchopneumonia - CT

Lobar Pneumonia: Fibrinosuppurative consolidation – whole lobe Rare due to antibiotic treatment. ~95% - Strep pneumoniae types 1,3,7& 2. Four stages: Congestion. Red Hepatization. Gray Hepatizaiton. Resolution.

Fibrinosuppurative consolidation – whole lobe

Rare due to antibiotic treatment.

~95% - Strep pneumoniae types 1,3,7& 2.

Four stages:

Congestion.

Red Hepatization.

Gray Hepatizaiton.

Resolution.

Lobar Pneumonia:

Lobar Pneumonia – Gray hep…

Lung Abscess: Focal suppuration with necrosis of lung tissue Strep, Staph & Gram negative & anaerobes Mechanism: Aspiration Post pneumonic Septic embolism Neoplasms Productive Cough, fever. Clubbing Complications: Systemic spread, septicemia.

Focal suppuration with necrosis of lung tissue

Strep, Staph & Gram negative & anaerobes

Mechanism:

Aspiration

Post pneumonic

Septic embolism

Neoplasms

Productive Cough, fever.

Clubbing

Complications: Systemic spread, septicemia.

Lung Abscess:

Lung Abscess:

Lung Abscess - Chronic:

Lung Fungal Abscess: Candida

Normal Lung

Normal Lung

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