PNEUMONIA - 1.pdf

PNEUMONIA-1 Dr. Mohamed alhassan Taha MBBS-MD/Clinical Pathology  INTRODUCTION  The Upper Respiratory System: Nose. Pharynx. Middle ear. Eustachian tubes. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 2 LOWER RESPIRATORY SYSTEM : TRACHEA, BRONCHI AND...

PNEUMONIA-1 Dr. Mohamed alhassan Taha MBBS-MD/Clinical Pathology  INTRODUCTION  The Upper Respiratory System: Nose. Pharynx. Middle ear. Eustachian tubes. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 2 LOWER RESPIRATORY SYSTEM : TRACHEA, BRONCHI AND LUNG 1/25/2022 DR. MOHAMED ALHASSAN TAHA 3 DISEASES OF THE LOWER RESPIRATORY TRACT  Include: oBronchitis; oBronchiolitis oPneumonia. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 4 Definition: - Is defined broadly as inflammation of lung parenchyma. It is characterized pathologically by CONSOLIDATION of lung parenchyma and clinically by fever, cough, dysponea and chest pain in most cases. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 5 1/25/2022 DR. MOHAMED ALHASSAN TAHA 6 Classification by site (anatomic classification) Classification by etiology Clinical classification 1/25/2022 DR. MOHAMED ALHASSAN TAHA 7 a. Lobar pneumonia: involves all/ part of lobe. b. Broncho pneumonia: patchy distribution involving scattered lobules. c. Interstitial pneumonia: - characterized by diffuse infiltration of interstitial areas between alveoli. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 8 1/25/2022 DR. MOHAMED ALHASSAN TAHA 9 Classification by etiology: a. BACTERIAL b. Viral; c. Fungal d. Protozoal 1/25/2022 DR. MOHAMED ALHASSAN TAHA 10  CLASSIFICATION BY THE ORIGIN OF INFECTION : (a) Community-acquired pneumonia (CAP): - Occurs out side of hospitals. - Viral, Streptocoous pneumoniae. (b) Hospital -acquired pneumonia (HAP): - Occurs in people 48 hrs or more after being hospitalized. - It is very serious. - Causes include many Gram-negative bacilli organisms 1/25/2022 DR. MOHAMED ALHASSAN TAHA 11 Aspiration Pneumonia:: Occurs in markedly deplitate or unconscious patients. It results in partly chemical (gastric acid) and partly bacterial pneumonia. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 12 CLASSIFICATION ACCORDING TO THE PATIENT HEALTH CONDITION: Primary pneumonia: Pneumonia occurring in previously healthy person Secondary pneumonia: Pneumonia occurring in person who have underlying lung abnormality (e.g.. COPD) that predisposes them to pneumonia. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 13  CLINICAL CLASSIFICATION  Typical pneumonia: Atypical Pneumonia 1/25/2022 DR. MOHAMED ALHASSAN TAHA 14  Typical Pneumonia Atypical Pneumonia Onset Sudden onset More insidious Organisms Strepto / others Mycoplasma Chlamydia legionella Type Broncho/lobar Interstitial Clinical High grade Low grade features fever fever Non-productive cough Flu- like symptoms 1/25/2022 DR. MOHAMED ALHASSAN TAHA 15  Bacteria are the most common cause of pneumonia. oGram - positive: - Streptococcus pneumoniae - Staphylococcus aureus. oGram - negative: - Haemophilus influenzae. - Klebsiella pnumoniae. - E.coli. - Pseudomonas. oOthers: atypical pneumonia. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 16  PATHOPHYSIOLOGY 1/25/2022 DR. MOHAMED ALHASSAN TAHA 17  PATHOPHYSIOLOGY When respiratory system fails to filter organisms; or when the I.S is weak ; pneumonia occurs. Pathogen enters the lungs through by:  aspiration of organisms residing in the throat or the nose.  inhalation of small droplets  bacteria can spread also via the blood. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 18  PNEUMONIA- STAGES : oFour stages are classically described: 1- Acute Congestion 2- Red Hepatization 3- Grey Hepatization 4- Resolution 1/25/2022 DR. MOHAMED ALHASSAN TAHA 19 : o1- Acute Congestion; First 24hrs. Characterized by vascular congestion, intra alveolar fluid (Oedema). Macroscopically the affected lobe is heavy, dark red and firm. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 20 1/25/2022 DR. MOHAMED ALHASSAN TAHA 21 2. Red hepatization: - 2nd – 4th days of diseases. - affected lungs resembles the liver in consistency, - microscopically, capillary engorgement persists and the exudates in alveolar spaces contain fibrin, large numbers of RBCs and numerous neutrophils. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 22 1/25/2022 DR. MOHAMED ALHASSAN TAHA 23 - Grey hepatization: 5 - 7 days. The lung is dry, grey and firm because the red cells are lysed. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 24 1/25/2022 DR. MOHAMED ALHASSAN TAHA 25 4- Resolution. - is the final stage. - begins with the 8th day. - macrophages remove the exudate from the alveoli. - the normal architecture is restored and the lung is re-inflated. 1/25/2022 DR. MOHAMED ALHASSAN TAHA 26 1/25/2022 DR. MOHAMED ALHASSAN TAHA 27 1/25/2022 DR. MOHAMED ALHASSAN TAHA 28