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Respiratory system

Respiratory system. ا.م.د.بيداء حميد عبدالله. Pulmonary infection. It can be caused by : Viral, bacterial, fungal and mycoplasma infection. Bacterial infection: Bacterial invasion of the lung parenchyma will cause an exudative solidification (consolidation) of the lung tissue.

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Respiratory system

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  1. Respiratory system ا.م.د.بيداء حميد عبدالله

  2. Pulmonary infection It can be caused by : Viral, bacterial, fungal and mycoplasma infection. Bacterial infection: Bacterial invasion of the lung parenchyma will cause an exudative solidification (consolidation) of the lung tissue. This is called (bacterial pneumonia).

  3. Pathogenesis: Normal lung is FREE from bacteria due to the presence of defense mechanisms: • Nasal clearance :by sneezing, blowing& mucous secretion. • Trachiobronchial clearance: by mucociliary action in which the foreign particles are either swallowed or expectorated • Alveolar clearance: by the alveolar macrophages  lymphatic circulation.

  4. Pneumonia results whenever these defense mechanisms are impairedor the host resistance get lowered (chronic diseases, immune deficiency, leucopenia). These clearing mechanisms can be interfered with e.g: • Loss or suppression of cough reflex (coma, anesthesia) , this may  gastric aspiration.

  5. 2 . Injury to the mucociliary apparatus e.g cigarette, inhaled hot or corrosive gases,viral diseases or genetic diseases (immotile cilia syndrome). 3 . Interference with phagocytosis. 4 . Pulmonary congestion and pulm. Edema. 5 . Accumulation of secretion e.g cystic fibrosis& bronchial obstruction.

  6. Etiology : We have TWO types of pneumonia : 1- Bronchopneumonia • Caused by staphylococcus, streptococcus, pneumococcus, hemophilus influenzae. • The consolidation is patchy. • Occur in infancy and old age groups caused by low resistance. • Can complicate long term heart failure

  7. Bronchopneumonia

  8. 2 . Lobar pneumonia • 90-95% are caused by pneumococci. • Others are klebsiella pneumonia , staphylococcus, strept., H. influenza. • The consolidation involves a portion of a lobe or the whole lobe.

  9. Lobar pneumonia

  10. Morphology of lobar pneumonia: There are four stages of evolvement of lobar pneumonia , they are: • Stage of congestion • Stage of red hepatization • Stage of grey hepatization • Stage of resolution.

  11. Congestion stage Grossly: the lung is heavy and red in color. Mic.: • Alveolar vascular congestion • Intra-alveolar fluid with neutrophil + bacteria .

  12. Red hepatization Grossly: red, firm, airless, look like a liver. Mic.: • The inflammatory exudate composed of RBC+ neutrophil+ fibrin.

  13. Red hepatization

  14. Grey hepatization Grossly: grey –brownish , dry surface. Mic.: • The exudate is composed of fibrin+ WBC which is called (fibrino-suppurative) exudate.

  15. Early (organization) gray hepatization

  16. Gray hepatization

  17. Resolution stage The exudate undergo enzymatic digestion formation of granular debris, that is either resorbed & ingested by the macrophages or expectorated and coughed up.

  18. Morphology of Bronchopneumonia Grossly: the well developed lesion is 3-4 cm , red /yellow, slightly elevated. Mic.: The consolidating area shows acute suppurative inflammation rich in neutrophils , filling the bronchi, bronchioles, & adjacent alveolar spaces.

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