Professional Documents
Culture Documents
AND PULMONARY
INFECTION
Ella C. Lim, M.D., DPSP
ATELECTASIS
The long of lung volume due to
inadequate expansion of the air
spaces (collapse).
Types:
Resorption Atelectasis
Compression Atelectasis
Compression Atelectasis
Air or fluid in the pleural cavity
under increased pressure (e.g.,
tension pneumothorax, effusion)
collapses small airways under the
pleura.
Resorption Atelectasis
Airway obstruction prevents air
from reaching the alveoli; May
RESORPTION ATELECTASIS
Causes of obstruction:
Mucous or mucoplurulent plug
bronchogenic carcinoma
Maternal diabetes
Cesarean section
Tuberculosis
Pneumonia
Other pulmonary
infections
TUBERCULOSIS
Epidemiology:
Inhalation of the bacterium (droplet
infection)
Screening: PPD skin test – does not
distinguish active from inactive
disease
Primary TB
initially localizes in a subpleural
location (upper part of the lower
lobes or lower part of the upper
TUBERCULOSIS
Ghon complex – spread of infection
to hilar lymph nodes with caseous
necrosis in nodes
Usually resolves – calcified
granuloma or area of scar tissue
(may be a nidus for reactivation TB)
Secondary (reactivation) TB
Cavitary lesion involves one or both
apices in the upper lobes
TUBERCULOSIS
Complications of secondary
(reactivation) TB:
Miliary spread in lungs – invasion into
the bronchus or lymphatics
TUBERCULOSIS
Ghon complex
Calcified lymph nodes
Subpleural nodule
CXR & photo: Note a calcified, well-
circumscribed nodule in the left lung -
an old healed focus of primary
tuberculosis; characteristically
peripheral in location.
Other calcified nodules can be seen in
the CXR in the left hilar region where
the clavicle appears to touch the arch
TUBERCULOSIS
Secondary, or reactivation
tuberculosis: occurs years after
the primary infection, most
commonly involves the apex of
the lung - typically causes
caseous necrosis and cavitation.
TUBERCULOSIS
TUBERCULOSIS
Cystic cavities
Patchy consolidation
Note:
The cavities in the upper lobes -
pathologic & radiographic findings in
secondary, or reactivation
tuberculosis.
Patchy consolidation is present in the
upper lobe - may represent either
superimposed bronchopneumonia or
progressive spread of tuberculosis.
TUBERCULOSIS
TUBERCULOSIS
Caseous necrosis
Leprosy
Fungal infections
FUNGAL PULMONARY INFECTION
TUBERCULOSIS
Caseous necrosis
TUBERCULOSIS
Atypical
BRONCHOPNEUMONIA
LOBAR PNEUMONIA
PNEUMONIA
Streptococcus
pneumoniae
PNEUMONIA
Abscess formation
Empyema
LABORATORY FINDINGS:
Positive gram stain, neutrophilic
leukocytosis
PNEUMONIA
PNEUMONIA
Cardiac silhouette
Infiltrate
Note: The usual angle between
the right heart border and the
right diaphragm has been lost.
Diffuse infiltrate extends to the
fissure between the right middle
and right lower lobes.
This is a lobar pneumonic
PNEUMONIA
Bronchopneumonia tends to be
patchy, although, if severe, even
bronchopneumonia may become
confluent and involve an entire
lobe of lung.
BRONCHOPNEUMONIA
BRONCHOPNEUMONIA
Bronchopneumonia
Abscess
Microabscesses in areas of
consolidation
BRONCHOPNEUMONIA
Staphylococcus aureus
Klebsiella pneumoniae
type 3 Pneumococcus.
BRONCHOPNEUMONIA
BRONCHOPNEUMONIA
Bronchopneumonia
Normal Lung
PNEUMONIA
Bronchopneumonia is patchy
Lobar pneumonia is diffuse, complete
or almost complete consolidation of a
lung lobe
See contrast between the stages of
red hepatization (right) and gray
hepatization (left).
The lower lobes are expanded
LOBAR PNEUMONIA
Congested alveolar septa
Interstitial pneumonitis
Clinical presentation of IP -
nonproductive cough, fever, and
malaise. Pathologically, there is a
lymphoplasmacytic infiltrate in the
alveolar septa. Note the absence of
inflammatory cells in the alveolar
LOBAR PNEUMONIA
CLINICAL FINDINGS:
Insidious onset with low grade fever
FUNGAL PNEUMONIA
FUNGAL PNEUMONIA
Pulmonary arterial wall
Fungal hyphae
Gross findings:
Vary in size and location
Those due to aspiration are primarily
on the RIGHT side of the lung
Most common aspiration site –
LUNG ABSCESS
Clinical Findings:
Spiking fever with productive cough –
foul smelling sputum due to
anaerobes (e.g., Fusobacterium)
CXR – cavitation with air-fluid level