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
A. Necrosis and suppuration with formation of one or several abscesses
usually below the pleura and almost invariably caused by hemolytic
streptococci.
B. Interstitial suppurative pneumonia caused by hemolytic streptococcus.
C. Multiple abscesses in clusters caused by staphylococci.
Suppurative pneumonia with necrosis and abscess formation will be
discussed in this section. Pulmonary abscesses which occurred in 43
autopsies may be included in this group; in 4 of these autopsies abscess
and interstitial suppurative pneumonia occurred in the same individual.
These abscesses were much more frequently situated in the lower than in
the upper lobes and more often in the right than in the left lung. In
most instances there was one or several abscesses situated below the
pleura of one lobe; occasionally abscesses occurred in two lobes of the
same lung or in both lungs. The distribution was as follows: Abscess in
only one lung occurred in right upper lobe in 6 autopsies; middle lobe,
3; lower lobe, 15; left upper lobe, 2; lower lobe, 16. Abscesses
occurred in both right and left lower lobes, twice. The usual situation
was at the lower and posterior part of the lower lobe at or near the
basal edge, less frequently below the posterior border or upon the basal
surface of the lobe. These abscesses in almost every instance were found
immediately below the pleural surface, so that they appeared upon the
pleura as opaque yellow spots usually surrounded by narrow zones of
hemorrhage. In one instance (Autopsy 376) the abscess cavity was
separated from the pleural cavity by remains of the pleura which was as
thin as tissue paper and in other instances perforation had occurred
(Fig. 9). In Autopsy 480 the abscess cavity which had perforated the
pleura was in free communication with a bronchus of medium size.
In most instances of suppurative pneumonia there have been associated
lesions of bronchopneumonia which have been peribronchiolar, hemorrhagic
or lobular and have exhibited no unusual characters. The abscess or
abscesses are situated within an area of pneumonic consolidation which
is not limited by lobule boundaries and has not the characters of
bronchopneumonic consolidation. In some instances this consolidation is
limited to a zone immediately about the abscess, but often it involves
the greater part of a lobe. The tissue is laxly consolidated and flabby;
on section it has a dull, conspicuously cloudy appearance and is grayish
red, pinkish gray or gray; it is homogeneous or very finely granular.
Turbid gray fluid, which sometimes resembles thin pus, oozes from the
cut surface.
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