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THE LUNG By Dr  Raana   Akhtar THE LUNG By Dr  Raana   Akhtar

THE LUNG By Dr Raana Akhtar - PowerPoint Presentation

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THE LUNG By Dr Raana Akhtar - PPT Presentation

PULMONARY INFECTIONS URTI PNEUMONIA Impaired local defence mechanisms loss of cough reflex defective mucociliary actionsecretions in airwaysinterference with phagocytosisamppulmonary edema ID: 646188

lung pneumonia acquired abscess pneumonia lung abscess acquired amp aspiration community cells chronic macrophages suppurative bronchopneumonia lobar atypical pulmonary

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Slide1

THE LUNG

By Dr

Raana

AkhtarSlide2
Slide3
Slide4
Slide5

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