REORIENTATION PROGRAM clinical aspect OF PNEUMONIA

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REORIENTATION PROGRAMclinical aspect OF
PNEUMONIA
Dr.Hitesh Purohit M.D.(Hom.) Academic
Convener, HOD Dept Of M.M. Smt. Malini Kishore
Sanghvi Homoeopathic Medical College, Miyagam -
karjan
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PNEUMONIA
DEFINITION Inflammation of the distal lung
parenchyma ? Terminal Airways. ?
Alveolar Spaces. ? Interstitium.
QUALIFICATION With words that imply ?
Cause. ? Mechanism. ? Anatomical
Site. ? Clinical Course. Eg ?
Viral Bronchopneumonia. ? Aspiration
Pneumonia. ? Chronic Interstitial Pneumonia.
? Acute Bacterial Pneumonia.
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• 1. STAGE OF CONGESTION
• Developing bacterial infection.
• Lasts for about 24 hrs.
• Characterized by Vascular
  engorgement, Intra-alveolar fluid with
  Neutrophil, Presence of numerous bacteria.
• Grossly, Involved Lobe heavy, boggy, red
  subcrepitant.
• Clinically Crepts. dry cough chill
  fever

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• 2. STAGE OF RED HEPATIZATION
• ? no. Neutrophils Fibrin fill the alveolar
  spaces.
• Massive EXUDATION obscures pulmonary
  architecture.
• Extravasations of red cells causes the
  coloration seen on gross examination.
• White cells contains engulf bacteria.
• Presence of fibrinous or fibrosuppurative
  pleuritis.
• Gross examination Lobe appears Red, Firm,
  Airless with a liverlike consistency, hence term
  HEPATIZATION. Clinically Dullness, Bronchial
  breath. Symptrusty,rattling,bloody sputum

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• 3. STAGE OF GRAY HEPATIZATION
• Continuous accumulation of fibrin Progressive
  disintegration of inflammatory white cells red
  cells.
• Fibrinosuppurative exudate give gross appearance
  of GRAYISH-BROWN, DRY surface.
• When bacteria infection extends in to the
  pleural cavity, the intrapleural
  Fibrinosuppurative reaction produce called
  EMPYEMA.

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• 4. STAGE OF RESOLUTION
• Consolidated exudate within the alveolar spaces
  undergoes progressive enzymic digestion to
  produce Granular, Semifluid debris that is
  either reabsorbed, Ingested by macrophage, or
  Cough up.
• In above favorable condition lung parenchyma is
  restored to its normal state.
• Pleura reaction also similarly resolved, but
  more often it undergoes organization, leaving
  fibrinous thickening or permanent adhesions.
• Clinically Crepts. Profuse expectoration

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Lung Parenchyma Lobe or Lobe Bronchi.
BACTERIA Pneumococcal Staphylococcal
INFLAMMATION
EXUDATIVE SOLIDIFICATION
Acute Suppurative, Fibrinosuppurative.
Typical Presentation. O/E CXR Inhomogeneous
Infiltrates / Patchy / streaky opacities. Focal
opacities. Lobar
consolidation.