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
=Anatomic Diagnosis.=—Suppurative pneumonia with consolidation and
abscess in right lower lobe below pleura; purulent pleurisy on
right, seropurulent pleurisy on left side; beginning serofibrinous
pericarditis; fibrinopurulent peritonitis; purulent bronchitis.
The body is emaciated. The right pleural cavity contains 350 c.c. of
thick, creamy yellow pus in which are flakes of fibrin; the right
lung is collapsed and lies at the back and inner side of the cavity.
The left pleural cavity contains 500 c.c. of turbid, yellow,
seropurulent fluid in which is soft fibrin. The lower lobe of the
right lung is consolidated throughout, flabby, gray red and finely
granular on section. Below the pleura of the posterior border is a
wedge-shaped cavity with its base 1.5 cm. across, in contact with
the pleural surface. About the cavity consolidated tissue has an
opaque, yellow color. Bronchi in both lungs contain mucopurulent
fluid. The pericardial cavity contains 20 c.c. of turbid fluid; the
left auricular appendage is bound by a thin layer of fibrin to the
parietal pericardium.
The peritoneal cavity contains 100 c.c. of thick, creamy, yellow,
purulent fluid. Between the diaphragm and liver is a layer of
fibrin, in places 1.5 cm. in thickness; fibrin is present upon the
peritoneum overlying the kidneys and base of mesentery.
Bacteriologic examination shows the presence of hemolytic
streptococci, obtained in pure culture from the blood of the heart,
right pleural cavity and peritoneum. From the right bronchus are
grown S. hemolyticus, B. influenzæ and a few colonies of S. viridans
and staphylococcus.
=Autopsy 504.=—G. R. C., white, aged twenty-eight, farmer from
Alabama, had been in military service three months. Onset of illness
occurred six days before death, and two days later he entered the
hospital with fever (103.4° F.), pains in the abdomen and vomiting.
Consolidation at the bases of the lung was recognized on the day
following admission and on the day before death 900 c.c. of greenish
brown fluid were aspirated from the left pleural cavity.
=Anatomic Diagnosis.=—Interstitial suppurative pneumonia with
consolidation in left lower lobe; purulent pleurisy on both sides;
purulent pericarditis; purulent peritonitis; parenchymatous
degeneration of kidneys; acute splenic tumor.
The body is that of a large well-nourished man. The left pleural
cavity contains 975 c.c. of creamy, yellow fluid; right pleural
cavity contains 425 c.c. of purulent fluid thinner than that on the
left side. The left lung is collapsed; the posterior and lower half
of the lower lobe is consolidated, flabby, deep red and fleshy in
appearance. The interstitial septa are yellow, thickened with
bead-like enlargements and contains creamy purulent fluid which
flows away and leaves small cavities. This interstitial suppuration
is more advanced below the outer surface of the lobe than elsewhere.
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