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
Large mononuclear cells are occasionally fairly numerous within the
alveoli containing blood. These cells act as phagocytes ingesting red
corpuscles, so that at times they are filled with corpuscles.
Disintegration of red corpuscles occurs and brown pigment remains within
the cell. It is not uncommon to find numerous mononuclear pigment
containing cells which resemble those found with chronic passive
congestion of the lungs.
Lungs, the site of hemorrhagic peribronchiolar pneumonia, may undergo
chronic changes which will be described elsewhere.
The lesion which has been designated hemorrhagic peribronchiolar
pneumonia is that which Pfeiffer regarded as the characteristic type of
influenzal pneumonia. In the small bronchi containing pus and in lung
tissue, Pfeiffer states, influenza bacilli are predominant and present
in astonishing number in smear preparations. The demonstration of B.
influenzæ by cultures from pneumonic lung is mentioned by him but its
association with other microorganisms in such cultures is not discussed.
Microorganisms which we have isolated from the lungs of individuals with
hemorrhagic peribronchiolar pneumonia are as follows:
B. influenzæ 1
Pneumococcus 2
S. hemolyticus 10
B. influenzæ, pneumococcus 7
B. influenzæ, S. hemolyticus 3
B. influenzæ, staphylococcus 2
S. hemolyticus, B. coli 3
B. influenzæ, pneumococcus, staphylococcus 2
B. influenzæ, S. hemolyticus, staphylococcus 5
Pneumococcus, S. hemolyticus, staphylococcus 1
No organisms 2
——
Total 38
With this type of pneumonia B. influenzæ has not been isolated in pure
culture; B. influenzæ alone is recorded only once (Autopsy 435), but in
this instance the culture has been so obscured by contamination that the
occurrence of pneumococci or streptococci cannot be excluded; S.
hemolyticus has doubtless been present in this lung, for it has been
found in the heart’s blood, in the bronchus, and in the peritoneal
exudate of the same individual.
The incidence of pneumococci and hemolytic streptococci in this list
does not differ materially from that with peribronchiolar pneumonia
unaccompanied by extensive intraalveolar hemorrhage, though hemolytic
streptococci are somewhat more frequent with the hemorrhagic lesion. The
following table shows the frequency with which pneumococci and hemolytic
streptococci have penetrated into the blood:
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