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Lung Infections (Necrotizing pneumonia +
lung abscess
Causes:…
Lung Infections
Necrotizing pneumonia +
lung abscess
- Causes: aspiration, antecedent pneumonia,
septic embolism, neoplasia
- Morphology: central cavitation with granulation tissue
Clinical features:
- Cough with foul smelling sputum (sanguineous)
- Chest pain, weight loss
- Clubbing
Complications:
- Amyloidosis (TYPE AA)
- Hematogenous spread --> brain abscess
- Fistula
- Hemorrhage
- Empyema
- Pneumatocoele
-
Healthcare associated pneumonia:
- Nursing home, hospital visit, recent IV
antibiotic, hospitalized >2 days
- Higher mortality than CAP
-
Pseudomonas
Aeruginosa:
- CF patients, burn victims,
neutropenia
Hospital aquired pneumonia:
> 48 hours after admission OR
3 days after discharge
- Risk factors: immunosuppression, invasive device, prolonged antibiotic therapy
- SERIOUS + LIFE THREATENING
-
-
-
Chronic pneumonia
Fungi
- Room temp: grow as mold/hyphae
--> body temp: grow as yeast
- T cell immunity --> phagocytosis
by macrophages
- Caseating granulomas
Histoplasma capsulatum:
- Coin lesion
- Intracellular - inside macrophage cytoplasm
- Bird/bat droppings
Blastomyces dermatiditis:
- SUPPURATIVE granulomas
- Broad based budding
- Immunocompromised --> lead to brain abscess
- ARDS
Coccidioidomycoses = Valley Fever:
- CA + AZ
- Fever, malaise, IMMUNE RASH (erythema multiforme/nodosum)
- Lung lesions --> coin lesion
-
Aspiration pneumonia:
Combination of chemical injury (gastric acid) + polymicrobic (oral flora)
- Caused by inhalation of vomit, food, drink,
saliva into lungs
- Risk factor: decreased consciousness/gag, drugs/alcohol, vomiting
- Can form granulomas in lung