PULMONARY INFECTIONS URTI PNEUMONIA Impaired local defence mechanisms loss of cough reflex defective mucociliary actionsecretions in airwaysinterference with phagocytosisamppulmonary edema ID: 646188
Download Presentation The PPT/PDF document "THE LUNG By Dr Raana Akhtar" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
THE LUNG
By Dr
Raana
AkhtarSlide2Slide3Slide4Slide5
PULMONARY INFECTIONS
URTI
PNEUMONIA
Impaired local defence mechanisms.
- loss of cough reflex ,defective mucociliary action,secretions in airways,interference with phagocytosis&pulmonary edema.
Decreased resistance of the host.
Chronic diseases,immunologic deficiency, immunosuppressive agents and leucopenia.Slide6
PNEUMONIA
COMMUNITY ACQUIRED ACUTE PNEUMONIA
COMMUNITY ACQUIRED ATYPICAL PNEUMONIA
HOSPITAL ACQUIRED PNEUMONIA
ASPIRATION PNEUMONIA
CHRONIC PNEUMONIA
NECROTIZING PNEUMONIA &LUNG ABSCESS
PNEUMONIA IN IMMUNOCOMPROMISED HOSTSlide7
COMMUNITY-ACQUIRED ACUTE PNEUMONIAS
Streptococcus
pnemoniae
- gram positive
Haemophilus
influenzae
-gram negative
Moraxella
catarrhalis
Staphlococcus
aureus
Klebsiella
pneumonia
Pseudomonas
aeruginosa
Legionella
pneumophilaSlide8
PNEUMONIA
MORPHOLOGY
Lobar pneumonia
Bronchopneumonia
Four Stages Of Inflammatory Response
CONGESTION
RED HEPATIZATION
GREY HEPATIZATION
RESOLUTION
PLEURITIS
Slide9
SYMPTOMS OF PNEUMONIASSlide10
COMPLICATIONS OF PNEUMONIA
ABSCESS FORMATION
EMPYEMA
BACTEREMIC DISSEMINATION:
Metastatic
abscesses,endocarditis,meningitis
and
suppurative
arthritis.Slide11
BRONCHOPNEUMONIASlide12
BRONCHOPNEUMONIASlide13
BRONCHOPNEUMONIASlide14
BRONCHOPNEUMONIASlide15
LOBAR PNEUMONIASlide16
LOBAR PNEUMONIASlide17
COMMUNITY-ACQUIRED ATYPICAL PNEUMONIA
Mycoplasma
pneumoniae
Chlamydia
sppc
Coxiella
burnetti
Viruses:
Respiratory
Syncytial
virus
Parainfluenza
virus
Influenza A&B
Adenovirus
SARS virus
Slide18
COMMUNITY-ACQUIRED ATYPICAL PNEUMONIA
PATHOGENESIS
Attachment of the organism to URT epithelium
Necrosis of cells and an Inflammatory response
Extends to
alveoli,interstitial
inflammation
Damage to epithelium
Inhibit
mucociliary
clearance
Secondary
becterial
infectionsSlide19
COMMUNITY-ACQUIRED ATYPICAL PNEUMONIA
Morphology
Patchy or lobar
Unilateral or bilateral
Redblue
and congested
Interstitial inflammation within the walls of alveoli
Alveolar septa widened and edematous
Mononuclear
infammatory
infiltrate of
lymphocytes,macrophages
and plasma cells
Intra-alveolar
proteinaceous
material&cellular
exudateSlide20
Viral pneumonia with interstitial lymphocytic
infiltrate.sSlide21
HOSPITAL- ACQUIRED PNEUMONIA
Enterobacteriaceae
Pseudomonas
S.aureusSlide22
ASPIRATION PNEUMONIA
Unconscious patients
Repeated vomiting
Partly chemical pneumonia(gastric acid)
Bacterial pneumonia(oral flora)
Aerobes and anaerobes
Necrotizing pneumonia
Fulminating clinical course
Lung abscess is a common complicationSlide23
ASPIRATION PNEUMONIASlide24
ASPIRATION PNEUMONIASlide25
LUNG ABSCESS
LOCAL SUPPURATIVE PROCESS WITHIN THE LUNG characterized by NECROSIS OF LUNG TISSUE.
Etiology & Pathogenesis
Streptococci,
S.aureus,gram
negative
organisms.anaerobic
organisms in oral cavity
Bacteroides,Fusobacterium
and
Peptococcus
species in 60% cases.Slide26
LUNG ABSCESS
Aspiration of infective material
Post-pneumonic abscess
formatio
Septic embolism
Neoplasia
(post-obstructive)
Miscellaneous:
spread of infection from neighboring organ,
hematogenous
seeding
Primary Cryptogenic Lung abscessesSlide27
LUNG ABSCESS
MORPHOLOGY
Few mm to large cavities of 5 to6 cm
Single ,on right side due to aspiration
Multiple,basal
due to
pneumonia,septic
emboli
Suppurative
debri
in abscess cavity
Continued
infection,large
greenblack
multiloculated
cavities with poorly demarcated margins(gangrene of the lung)
SUPPURATIVE DESTRUCTION OF LUNG PARENCHYMA with CENTRAL AREA OF CAVITATION
Fibrous wall in chronic casesSlide28
LUNG ABSCESSSlide29
LUNG ABSCESSSlide30
CHRONIC PNEUMONIAS
Inflammatory reaction is
granulomatous
caused by
Bacteria (
M.tuberculosis
)
Fungi(
Histoplasma
capsulatum
,
Blastomyces
dermatitidis
,
Coccidiodes
immitis
)Slide31
Histoplasmosis
Histoplasma
capsulatum
infection
Acquired by inhalation of dust particles from soil contaminated with bird or bat
dropings
containing spores
Intracellular parasite of macrophages
Apical coin lesions on X-ray chest
Cough, fever &night sweats
Extrapulmonary
localized lesion in
mediastinum,adrenals,liver
and
meningesSlide32
Histoplasmosis
Macrophages (TNF)
Helper T-cells(INF gamma)
Morphology
Epitheloid
cell
granulomata
with
caseous
necrosis
Large areas of consolidation may
liquify
to form cavities
Lesions undergo fibrosis and concentric calcification(tree-bark appearance)
3 to 5 micron meter thin walled yeast may persist in tissues for years.
Fulminating Disseminated
Histoplasmosis
. Macrophages filled with fungal yeast.Slide33
BLASTOMYCOSIS
Blastomyces
dermatitidis
Pulmonary,Disseminted
& Primary
cutaneous
Consolidation ,
multilobar
infiltrates,perihilar
infiltrates or
miliary
infiltrates.
Suppurative
granulomas
5 to15-micron meter yeast cellsSlide34
Coccidioidomycosis
Inhalation of spores of
Coccidioides
immitis
Lung lesions in 10%.
Granulomatous
lesions
Nonbudding
sperules
filled with small
endospores
within macrophages and giant cellsSlide35
Chronic abscessing inflammationSlide36
TB LUNGSlide37
Pulmonary disease in HIV infectionSlide38
Pneumocystis
carinii
jirovesi