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1、Firststeptomakeyourdreamscometrueisto…...wakeup!—PaulValeryPathologyof PneumoniaDr.VenkateshM.ShashidharAssociateProfessorofPathologyFijiSchoolofMedicineIntroduction:5000sqmetersofarea….!(olympictrack)Filters>10,000Lofair/day…!Normallungsaresterile.Delicate,thinresp.mem–ga
2、sexch.Filter,humidify,sterilize,highlysensitive.RTI–Resp.tractinf.commonestinmedicalpractice.Enormousmorbidity&mortality.Pneumonia–inflammationofalveoli.NormalLungNormalLungEtiology:Decreasedresistance-General/immuneVirulentinfection-LobarpneumoniaDefectiveClearingmechanis
3、mCough/gagReflex–Coma,paralysis,sick.MucosalInjury–smoking,toxinaspirationLowAlveolardefense-ImmunodeficiencyPulmonaryedema–Cardiacfailure,embol.Obstructions–foreignbody,tumorsPatternsofLungdisorders:AirwayBronchitis,Bronchiectasis,Bronchiolitis.Tumors/CancerParenchymaPneu
4、monia.Lungabscess,TBHyalinemembranedis(HMD&ARDS)PneumoconiosisTumors/CancerPleura:Pleuraleffusion(TB)Tumors/Cancer*InfectionsPathogenesisofPulmonaryInfectionsStep1:EntryAspiration(iePneumococcus)Inhalation(ieMtbandviralpathogens)Inoculation(contaminatedequipment)Colonizati
5、on(inpatientswithCOPD)Hematogenousspread(patientswithsepsis)Directspread(adjacentabscess)Pathogenesis:Pathogenesis:PneumoniaTypes:EtiologicTypes:InfectiveViralBacterialFungalTuberculosisNonInfectiveToxinschemicalAspirationMorphologictypes:LobarBronchoInterstitialDuration:A
6、cuteChronicClinical:Primary/secondary.Typical/AtypicalCommunitya/hospitalaLobarPneumonia:wholelobe,exudation-consolidation95%-Streppneum.(Klebsiellainaged,DM,alcoholics)Highfever,rustysputum,Pleuriticchestpain.Fourstages:(*alsoinbronchopneumonia)Congestion–1d–vasodilatatio
7、ncongestion.RedHepatization2dExudation+RBCGrayHepatizaiton4dneutro&Macrophages.Resolution–8dfewmacrophages,normal.CongestionRedHepatisationGreyHepatizationResolutionPathogenesisofPneumoniaLobar Pneumonia:Lobar Pneumonia:LobarPneumonia–Grayhep…LobarPneumonia:LobarPneumonia:
8、CongestionLobarPneumonia:Redhepat.LobarPneumonia:Greyhepat.Broncho-pneumoniaBronchopneumo
