Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measlesOpie, Eugene L. (Eugene Lindsay)
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Epidemic Respiratory Disease: The pneumonias and other infections of the repiratory tract accompanying influenza and measles
The left lung over its lower half is covered by a thin layer of
fibrin. The tissue is crepitant throughout and moderately edematous.
Bronchi contain mucopurulent fluid.
Hemolytic streptococci in pure culture are obtained from the blood
of the heart, right pleural cavity and pericardium. No growth is
obtained on a plate inoculated with material from the right lower
lobe. The right bronchus contains hemolytic streptococci and B.
influenzæ.
The pleural surface of the right lung is covered by a thick layer of
fibrin which has undergone advanced organization. Fibrous septa
within the lung are much thickened by the presence of newly formed
fibrous tissue; the interstices of the tissue are distended and
contain fibrin into which fibroblasts and new blood vessels have
penetrated. Some lymphatics are plugged with fibrin and contain
polynuclear leucocytes, lymphoid and large mononuclear cells. In
several places organization of these thrombi is beginning. About the
blood vessels are thrombosed lymphatics in which polynuclear
leucocytes and mononuclear cells are equally abundant. Alveoli
immediately adjacent to blood vessels and to fibrous septa often
contain fibrin, and alveoli elsewhere contain desquamated cells in
abundance.
In association with hemolytic streptococci in the blood, pleura and
pericardium, there has been inflammation of the interlobular septa of
the lungs with acute lymphangitis; there has been no suppuration and the
lesion is in process of healing with new formation of fibrous tissue. It
is evident that this lesion, as well as pleurisy with advanced
organization, preceded the exacerbation of the patient’s illness which
occurred five days before death. The advanced chronic changes found at
autopsy indicate that the pulmonary and pleural lesions had their origin
during the illness which was present at the time of admission to the
hospital. Interstitial pneumonia caused by hemolytic streptococci was of
mild character and did not produce suppuration within the lung;
nevertheless, hemolytic streptococci which reached the pleura caused
empyema.
Suppurative Pneumonia with Multiple Clustered Abscesses Caused by
Staphylococci
In the preliminary report of this commission published in _The Journal
of the American Medical Association_, _loc. cit._, pg. 111, we described
suppurative pneumonia with multiple abscesses caused by staphylococci
and cited 4 instances of the lesion which followed influenza. Chickering
and Park[84] published in a subsequent number of the same journal an
account of staphylococcus pneumonia, a lesion which has heretofore
attracted very little attention.
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