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
Cultures show the presence of hemolytic streptococci in the blood of
the heart and in three plates from the lung; B. influenzæ and S.
aureus were found in the left bronchus.
The bronchi have wholly or partially lost their epithelium and there
is deep erosion of the walls. Cavities containing polynuclear
leucocytes occur within the alveolar tissue; in some instances pus
containing cavities are surrounded by alveolar tissue, but in other
places it is evident, that they have had their origin in bronchi. In
a short segment of the circumference the wall of the preexisting
bronchus is preserved and consists of squamous epithelium, vascular
connective tissue and smooth muscle. The remainder of the bronchus
has disappeared and a cavity is produced. The very irregular wall of
the cavity is formed by partially destroyed alveoli filled with
fibrin and leucocytes.
=Autopsy 387.=—C. M., white, aged twenty-one, laborer, resident of
Mississippi, had been in military service twenty-one days. Illness
began on September 22, nineteen days before death, and the patient
was admitted to the hospital on the same day with a diagnosis of
bronchitis; a diagnosis of bronchopneumonia was made on October 2,
nine days before death. The leucocytes on October 3 numbered 8000
(small mononuclear, 36 per cent; large mononuclear, 5 per cent;
polynuclear, 59 per cent).
=Anatomic Diagnosis.=—Acute bronchopneumonia with consolidation in
right upper lobe and hemorrhagic peribronchiolar consolidation in
left lower lobe; abscess below pleura in left lower lobe; purulent
pleurisy on both sides; edema of mediastinum; purulent bronchitis;
bronchiectasis.
There is advanced bronchiectasis, and bronchi with no visible
cartilage are dilated to from 4 to 8 mm. in diameter; they contain
purulent fluid which wells up from the cut surface. About dilated
bronchi there is in places dull red or grayish red consolidation
forming an encircling zone. Situated below the pleural surface
within an area of consolidation at the posterior border of the left
lower lobe there is a spot 3 cm. across where the tissue is yellow
and has in places undergone purulent softening. Several smaller
abscesses occur nearby.
Cultures from the blood of the heart and from the edematous
mediastinum contain hemolytic streptococci. From the abscess are
grown S. albus, Pneumococcus II and B. influenzæ. The purulent
contents of a small bronchus contains S. hemolyticus, B. influenzæ,
S. aureus and a few pneumococci.
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