Bronchopneumonia
Bronchopneumonia
8; View of the left lung with trachea identified to the left (T). € Upper and lower lobes identified by letter U and L, res- pectively. € The upper lobe and upper portion of the lower lobe are pink and normal looking. € The lower portion of the lower lobe has been opened and reveals bronchi with congested inflamed mucosa (arrow) and red consolidated adjacent parenchyma.


(Image Contrib. by:UCHC)(Description by: Melinda Sanders, M.D.)
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Bronchopneumonia
Etiology

• Variety of aspirated organisms.

• Organism dependent on whether community acquired in previously healthy patient (more likely Streptococcus) or

• Community acquired in patient with depressed pulmonary defenses such as a patient with chronic bronchitis (more likely Klebsiella or Pseudomonas spps) or

• Hospital acquired


Pathogenesis

• Aspiration of organisms results in inflammation and necrosis of underlying parenchyma

• Tends to scar if alveolar septae are destroyed


Epidemiology

• Common in hospitalized patients and contributes to the cause of death in moribund patients

• Most common community acquired pneumonia as well


Clinical

• Clinical course dependent on underlying disease processes

• Patients present with fever, cough and purulent sputum


General Gross Description

• Patchy distribution particularly around small airways

• Nodular, elevated, firm, airless regions

• Range from red to gray depending on age of the lesion

• Can become confluent to mimic lobar pneumonia


General Micro Description

• Bronchocentric lesions

• Neutrophils fill airway and surrounding alveoli

• Parenchymal destruction depends on organism

• Uninvolved parenchyma may contain acellular pink edema


Reference

• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 694-698.


• Current literature from PubMed at National Library of Medicine


Synopsis by: Melinda Sanders M.D., UCHC
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