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SUPPURATIVE LUNG DISEASES

SUPPURATIVE LUNG DISEASES. Bronchiectasis. * Def: persistent dilatation of medium sized bronchi accompanied by suppurative inflammation of their walls. * Etio-pathogenesis: I. Weakening of the bronchial wall by; a. Chronic suppurative inflammation: due to recurrent septic bronchopneumonia.

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SUPPURATIVE LUNG DISEASES

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  1. SUPPURATIVE LUNG DISEASES Bronchiectasis

  2. * Def: persistent dilatation of medium sized bronchi accompanied by suppurative inflammation of their walls. * Etio-pathogenesis: I. Weakening of the bronchial wall by; a. Chronic suppurative inflammation: due to recurrent septic bronchopneumonia. b. Congenital weakness: leads to congenital bronchiectasis. II. Bronchial obstruction: by foreign body, bronchial secretion or tumor.

  3. * N/E: - Dilated bronchi: • Cylindrical, fusiform or saccular • Bilateral. • Basal. • Has patchy distribution. • The bronchial lumen contains pus. • The bronchial mucosa: ulceratd. - The surrounding alveoli are: fibrotic and collapsed. - The pleura shows: pleurisy - Draining hilar L. nodes:enlarged

  4. * Complications: • Spread of infection: direct, lymphatic and blood. • Hemoptysis. • Lung abscess (post-bronchiectatic lung abscess). • 2ry amyloidosis. • Lung fibrosis. • Bronchogenic carcinoma (squamous cell carcinoma).

  5. PNEUMONITIS

  6. * Classification: 1. Bacterial pneumonia: lobar pneumonia & bronchopneumonia. 2. Viral (interstitial) pneumonia: influenza, measles, chicken pox. 3. Loeffler’s (parasitic) pneumonia: Bilharziasis, ascaris & ankylostomiasis. 4. Granulomatous pneumonia: T.B, sarcoidosis, leprosy, syphilis, actinomycosis . 5. Lipoid pneumonia: due to aspiration of oily nasal drops. 6. Irradiation pneumonia.

  7. LOBAR PNEUMONIA * Def: acute diffuse fibrinous inflammation of one or more lung lobes. * Etiology: • Age: middle age. • Predisposing factors: low resistance. • Causative organism: pneumococci. • Route of infection: droplet infection.

  8. * Pathogenesis: • Pneumococci are inhaled to reach alveoli. They cause acute inflammaion with excess fluid exudate. This fluid exudate pass from one alveolus to another rapidly through the inter- alveolar pores of cohn to involve the whole lung lobe. The fluid exudate expel air away from the alveoli producing a firm airless lobe leading to consolidation (hepatisation) of the affected lobe.

  9. BRONCHOPNEUMONIA * Def: Acute suppurative inflammation of bronchioles and adjacent alveoli characterized by patchy lung consolidation. * Etilogy: • Age: extremes of age (young & elderely). • Predisposing factors: low resistance and bronchitis. • Causative bacteria: staphylococci, streptococci & H. influenza. • Route of infection: endogenous invaders and exogenous invaders (droplet infection).

  10. * N/E: • Bilateral. • Basal. • Multiple consolidated yellowish patches exuding pus on pressure. Several patches may coalesce to produce confluent bronchopneuomonia. • Enlarged hilar L. nodes.

  11. * M/P: I. The bronchioles show: • Their lumen shows: necrotic epithelial cells, polymorphs & pus cells. • Their lining: ulceration. • Their walls: congested capillaries, neutrophils and pus cells & exudate. II. The adjacent alveoli show: 3 successive zones: zone of alveolitis then zone of alveolar collapse and a zone of alveolar dilatation (compensatory emphysema).

  12. * Complications: • Spread of infection: direct, lymphatic and blood (toxaemia, septicaemia). • Lung fibrosis due to failure of resolution. • Post-pneumonic lung abscess. • Bronchiectasis.

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