Bronchopneumonia

 

 

 

 

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 A 70 yr old bedridden man was found dead in his 1-room flat.  An autopsy was performed.

 

1.    What is your diagnosis?

 

Bronchopneumonia.

 

2.    List the main histological features.

Patchy consolidation of alveolar tissues / spaces (multinucleated, bilateral, basal, mutilobar)

Suppurative, neutrophil rich exudates fills the bronchi, bronchioles and adjacent alveolar spaces

 

3.    What pathological process does it represent?

Acute inflammation as a result of bacterial infection of the lung parenchyma

 

4.    What clinical manifestations might he have had?

Malaise, fever, cough with sputum

Pleuritic pain, pleuric friction pain (pleural involvement)

Focal opacities on CXR

 

5.    Which anatomy sites of the lung are involved most severely?

Lower lobes basal part due to gravitation of exudate

 

6.    True-false MCQs

This condition is associated with

 

a.    Infection by Streptococcus pneumoniae T

b.    Group B Streptococcus in newborn T

c.    Weak host defence mechanisms and infection by bacterial that are commonly present in the oropharynx and nasopharynx T

d.               d.    A higher incidence in infancy and old age T

 

 

7.    What complications might arise from this condition?

 

Local:                     Abscess

                                Pleural empyema

                                Organisation (fibrosis)

                                Bronchiectasis

Systemic:                bacteremic dissemination (pyemia)

 

8.    What may be the cause of death?

 

Endocarditis

Empyema, meningitis, pericarditis

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