Bacterial Infections of Lung

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Bacterial Infections of Lung

PCP

Honeycomb appearance

Silver methenamine stain

Perihilar shadow

T cell count < 200

Mycoplasma Pneumonia

"Walking Pneumonia" = Asymptomatic pneumonia, but CXR looks bad

"Primary atypical pneumonia"

Cold agglutinins (50%)

Serum agglutinates group O blood at freezing point (0 deg C)

Community-acquired pneumonia

How Infections Develop

Bacteria

S. aureus

P. aeruginosa

Nosocomial

I.V. Lines

Intubation

Routes

Hematogenous spread

Inhalation

Predisposing Factors

Hypogammaglobulinemia

Distrubance of the phagocytic actions

Mucociliary apparatus dysfunction

Loss or suppression of cough reflex

"Atypical" Pneumonias

DNA

CMV

Neonates

Immunocomp

VZV

Pregnant women

Mortality Rate = 42%

HSV

Ground glass nuclei

Intranuclear inclusion surrounded by halo

Forms of Infxn

Hemorrhagic parenchymal nodules

Ulcerative tracheobronchitis

Adenovirus

Smudge cells

Military recruits

RNA

SARS-CoV

Influenza A

Neuraminidase

Ameliorate future infection

Hemagglutinin

Prevent future infection

Headache

Muscle pain

Human metapneumovirus

RSV

MGCs

Less than 1 year old

Lung Abscess

Localized suppurative process with necrosis of lung tissue

young adults

60% anaerobic organisms

Copious foul-smelling sputum

chest pain

Morphology

Micro

Neutrophil destruction w/ necrosis

Suppurative process (neutrophil destruction) w/ cavitation (necrosis)

Gross

Necrotic, cavitary mass

CXR

Cavitary mass w/ Air-fluid level

Sx

Chest pain

Copious foul-smelling sputum

Fever

Cough

Bacterial Pneumonia

Foamy macrophages

Lipoid pneumonia

Obstruction

Endogenous

Mineral Oil (Laxative)

Exogenous

Gram negative enterics, anaerobes, gag reflex

Aspiration pneumonia

Location depends on patient's position:

Lying on back --> apical segment of Right lower lobe

Variable

Oropharyngeal

Onset: < 24 h (Others are relatively immediate)

Low mortality

Isotonic fluids

High mortality

Large particulate matter

Hyper/Hypotonic fluids

Gastric acid

Elderly smoker, Cl- resistant, Cooling system

Legionnaire's Disease

Strep Pneumo (90-95%)

Lobar pneumonia

Patchy exudative consolidation

Bronchopneumonoia