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
When bronchiectasis occurs throughout a whole lung, usually the left, or
in both lungs, the lesion is more advanced and conspicuous (Fig. 26).
There is diffuse dilatation of small and medium-sized bronchi. Dilated
bronchi with deeply injected mucosa and filled with yellow mucopurulent
fluid, are seen throughout the sectioned lung. A bronchus cut
longitudinally may have a nearly uniform diameter of from 5 to 9 mm. for
a distance of 5 or 6 cm., maintaining this diameter to within 1 cm. of
the pleural surface, where normally only small bronchi occur.
More advanced bronchiectasis is represented by the occurrence of
spherical bronchiectatic cavities, having a diameter from 1 to 2.5 cm.
In some instances there have been two or three of these cavities but
occasionally there may be many. Cylindrical dilatation of the bronchi
usually occurs widely distributed in the lungs. In Autopsy 440 a small
bronchus, cut longitudinally, was dilated to a diameter of 5 mm. for a
distance of 5 cm. and terminated in a spherical cavity 2 cm. in
diameter; there was another smaller spherical cavity nearby and dilated
bronchi occurred elsewhere. In Autopsy 467, in the upper part of the
lower lobe, two spherical cavities 1 and 1.5 cm. in diameter
communicated with a bronchus of medium size.
Autopsies with bronchiectasis are listed in the order of the duration of
illness to show the parallel increase in the severity of the lesion
(Table LI). In 2 instances (Autopsies 244 and 314) bronchiectatic
cavities surrounded by firm fibrous tissue have evidently existed before
the onset of the fatal illness, which has lasted in one instance
approximately four and in the other six days; these autopsies have been
omitted from the table.
The table shows that bronchiectasis observed within twelve days after
onset of illness with symptoms of influenza is moderately advanced and
almost invariably limited to the left lower lobe and usually to the base
of the lobe. Advanced dilatation, indicated by the formation of
spherical or cylindrical cavities, occurs with increasing frequency as
the duration of the respiratory disease increases.
Bronchiectasis has been almost invariably associated with purulent
bronchitis. The dilated bronchi contain mucopurulent material and
throughout the lungs the same condition is usually widespread. Among 137
instances of purulent bronchitis bronchiectasis consequent upon
influenza has been present in 50.
TABLE LI
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