Pathology of Pneumnia课件.ppt

Pathology of Pneumonia Dr. Venkatesh M. Shashidhar Associate Professor of Pathology Fiji School of Medicine Introduction: 5000 sq meters of area….! (olympic track) Filters 10,000 L of air / day…! Normal lungs are sterile. Delicate, thin resp. mem – gas exch. Filter, humidify, sterilize, highly sensitive. RTI – Resp. tract inf. commonest in medical practice. Enormous morbidity mortality. Pneumonia – inflammation of alveoli. Normal Lung Normal Lung Etiology: Decreased resistance - General/immune Virulent infection - Lobar pneumonia Defective Clearing mechanism Cough/gag Reflex – Coma, paralysis, sick. Mucosal Injury – smoking, toxin aspiration Low Alveolar defense - Immunodeficiency Pulmonary edema – Cardiac failure, embol. Obstructions – foreign body, tumors Patterns of Lung disorders: Airway Bronchitis, Bronchiectasis, Bronchiolitis. Tumors / Cancer Parenchyma Pneumonia. Lung abscess, TB Hyaline membrane dis (HMD ARDS) Pneumoconiosis Tumors / Cancer Pleura: Pleural effusion (TB) Tumors / Cancer Pathogenesis of Pulmonary Infections Step 1: Entry Aspiration (ie Pneumococcus) Inhalation (ie Mtb and viral pathogens) Inoculation (contaminated equipment) Colonization (in patients with COPD) Hematogenous spread (patients with sepsis) Direct spread (adjacent abscess) Pathogenesis: Pathogenesis: Pneumonia Types: Etiologic Types: Infective Viral Bacterial Fungal Tuberculosis Non Infective Toxins chemical Aspiration Morphologic types: Lobar Broncho Interstitial Duration: Acute Chronic Clinical: Primary / secondary. Typical / Atypical Community a / hospital a Lobar Pneumonia: whole lobe, exudation - consolidation 95% - Strep pneum.(Klebsiella in aged, DM, alcoholics) High fever, rusty sputum, Pleuritic chest pain. Four stages: (*also in bronchopneumonia) Congestion – 1d – vasodilatation congestion. Red Hepatization 2d Exudation+RBC Gray Hepatizaiton 4d neutro Macrophages. Resolution – 8d few macrophages, normal. Pathogenesis of Pneumonia Lobar Pneumonia: Lobar Pneumo