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
With this peribronchial pneumonia the smallest bronchi are distended
with pus and their walls are infiltrated with polynuclear leucocytes,
lymphoid and plasma cells. In a broad zone encircling the bronchus the
alveoli are filled with plugs of fibrin. Bronchioles are similarly
distended with polynuclear leucocytes; the alveoli which occur upon the
wall of the bronchiole are often limited to one side of the wall and are
filled with fibrin. This fibrin occasionally projects into the lumen of
the bronchiole and forms a continuous layer in contact with the wall on
the same side. The alveolar duct and infundibulum are distended with
polynuclear leucocytes. The alveoli upon the wall of the alveolar duct
and upon the proximal part of the infundibulum are filled with fibrin.
The bronchus, bronchiole, alveolar duct and part of the infundibulum are
thus surrounded by a continuous zone of alveoli containing fibrin. The
alveoli about the distal part of the infundibulum may be filled with
polynuclear leucocytes. Lung tissue between adjacent zones of fibrinous
pneumonia may contain serum and desquamated epithelial cells.
Organization of peribronchial fibrin was found in 10 of the 22 autopsies
in which peribronchial fibrinous pneumonia had been found. Fibroblasts
have invaded the fibrin and newly formed capillaries have penetrated
into it. In some instances the interalveolar septa are thickened and
infiltrated with lymphoid and plasma cells, and in 7 instances there was
chronic pneumonia with thickening and mononuclear infiltration of the
interstitial tissue about the bronchi and blood vessels, and elsewhere.
The duration of the fatal illness in 12 instances with no organization
was usually from ten days to two weeks, though in 3 instances there was
no organization although the respiratory disease had lasted from
seventeen to nineteen days (average duration with no organization, 13.5
days). The duration of illness in 10 instances with organization of
fibrin was slightly less than three weeks (average 18.9 days). These
figures do not accurately represent the duration of pneumonia which
usually develops after a period of several days following onset of
influenza.
This group of instances of peribronchial fibrinous pneumonia has offered
an opportunity to study the bacteriology of pneumonia with organization
and to determine if it presents any unusual characters. The bacteriology
of autopsies with peribronchial fibrinous pneumonia with no organization
is shown in Table XLIII:
TABLE XLIII
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