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
In a foregoing section we have described instances of interstitial
suppurative pneumonia unaccompanied by chronic changes, and in the
present section we have described instances of unresolved
bronchopneumonia with no infection by hemolytic streptococci. We have
pointed out that the incidence of streptococcus infection with
unresolved bronchopneumonia does not materially differ from that with
acute bronchopneumonia even though the greater duration of the disease
gives more opportunity for infection. In some of the autopsies made by
MacCallum at Fort Sam Houston, lesions of streptococcus infection
doubtless coexisted with unresolved bronchopneumonia.
In the 3 autopsies described below, interstitial suppurative pneumonia
with empyema caused by hemolytic streptococcus occurs in association
with unresolved bronchopneumonia.
=Autopsy 420.=—J. E. S., white, aged thirty-two years, born in
England and resident of Los Angeles, Cal., had been in military
service one month. Onset of illness began on October 3, eleven days
before his death. He was admitted to the hospital on the following
day with the diagnosis of influenza and acute bronchitis. Pneumonia
believed to be lobar was recognized eight days after admission.
=Anatomic Diagnosis.=—Unresolved bronchopneumonia with hemorrhagic
peribronchiolar consolidation in right lung; interstitial
suppurative pneumonia with consolidation in left upper lobe;
fibrinopurulent pleurisy; purulent bronchitis.
The left pleural cavity contains 200 c.c. of turbid yellow fluid in
which are flakes of fibrin. In the inner and upper part of the left
upper lobe there is an area of consolidation where the tissue has a
cloudy, pinkish gray color and is finely granular on section. Here
the interstitial septa are distended by edema, so that they are in
places 0.5 c.c. across; in some spots they have a bright yellow
color. In the posterior parts of the middle and lower lobes there is
flabby consolidation where the tissue has a cloudy, red color with
scattered ill-defined yellow spots.
Bacteriologic examination shows the presence of hemolytic
streptococci in the blood of the heart; hemolytic streptococci with
B. influenzæ and S. aureus in the left lung and S. hemolyticus with
S. aureus in the right lung.
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