Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
History
Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
The difficulty of separating lobar and bronchopneumonia following
influenza has been increased by the frequent combination of the two
lesions in the same individual. There were 34 instances in which lobar
and bronchopneumonia occurred together. The anatomic diagnosis of lobar
pneumonia was made only when lobes or parts of lobes were firmly
consolidated and exhibited the characters of the lesion enumerated
above; in several instances, in which there was some doubt concerning
the nature of the lesion, microscopic examination was decisive. The
associated bronchopneumonic lesions represented all the types which have
been associated with influenza. In the group of 34 cases of coexisting
lobar and bronchopneumonia, lobular consolidation occurred 10 times,
peribronchiolar consolidation 14 times (recognized in all but 4
instances by microscopic examination), hemorrhagic peribronchiolar
consolidation 9 times, peribronchial pneumonia 4 times. The intimate
relation of these lesions to changes in the bronchi is well shown by the
frequent presence of purulent bronchitis. The associated lesions of the
bronchi in these cases were as follows: purulent bronchitis in 23
instances; peribronchial hemorrhage in 6; bronchiectasis in 11. The
frequency of purulent bronchitis and other bronchial lesions in
association with coexisting lobar and bronchopneumonia is in sharp
contrast with the occurrence of these lesions in association with lobar
pneumonia alone; with 69 instances of lobar pneumonia alone purulent
bronchitis occurred 17 times and bronchiectasis once.
Lobar pneumonia following influenza passes through the usual stages of
red and gray hepatization. Red hepatization was found 16 times, combined
red and gray hepatization 28 times, and gray hepatization 20 times. The
average duration of pneumonia with red hepatization was 3.7 days, with
combined red and gray hepatization 5.1 days and with gray hepatization
7.5 days. These figures, it will be shown later, have some importance in
relation to the stage at which hemolytic streptococcus infects lungs the
site of lobar pneumonia.
=Bacteriology of Lobar Pneumonia.=—Table XXX is compiled with the
purpose of determining the bacteriology of the bronchi, lungs and
heart’s blood in autopsies performed on individuals with lobar
pneumonia. In some instances bacteriologic examination of one or other
of these organs was omitted; the percentage incidence is an index of the
presence of pneumococci, hemolytic streptococci, staphylococci or B.
influenzæ in the bronchi, lungs or heart’s blood and measures the
invasive power of these microorganisms during the course of lobar
pneumonia following influenza.
TABLE XXX
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