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
Microscopic examination shows that the epithelium of the bronchi has
undergone hypertrophy; the wall is infiltrated with lymphoid and
plasma cells and thickened by new formation of fibrous tissue; there
is similar thickening of adjacent alveolar septa and alveoli, often
lined by cubical cells, are diminished in size. Connective tissue
about the blood vessels and the interstitial septa are thickened and
infiltrated with mononuclear cells. In parts of the lung the
interstitial septa are edematous and contain polynuclear leucocytes,
in some places in great number. Lymphatics are greatly dilated and
filled with polynuclear leucocytes which in the center of some
lymphatics have undergone necrosis. In one place a small abscess is
in contact with a distended lymphatic. Lymphatics contain
Gram-staining cocci in pairs and short chains, present in immense
number where necrosis has occurred.
=Autopsy 433.=—B. J., white, aged twenty-seven, from Arkansas, has
been in military service one month. Onset of illness was on
September 28, nineteen days before death, with cough and
expectoration. Pneumonic consolidation was recognized two days later
and 20 c.c. of cloudy fluid were aspirated from the left chest on
the same day. Hemolytic streptococci were found in a culture from
the throat nine days before death.
=Anatomic Diagnosis.=—Unresolved bronchopneumonia with
peribronchiolar and confluent lobular consolidation; interstitial
suppuration of the right lower lobe; purulent bronchitis;
fibrinopurulent pleurisy.
The right pleural cavity contains 700 c.c. of yellowish gray
purulent fluid containing flakes of fibrin. The left pleural cavity
contains seropurulent fluid localized over the external part of the
lung.
The right lung is voluminous and free from consolidation save at the
lower and posterior part of the lower lobe where the tissue is deep
red and studded with firmer spots of yellow color clustered about
the bronchi. In places the interstitial septa are thickened and
yellow. Surrounding some of the bronchi near the apex of the left
lung are red patches of consolidation.
Culture from heart’s blood remained sterile. S. hemolyticus was
grown from right pleural cavity, and S. hemolyticus and B. influenzæ
were grown from the right lung. Culture from the left lung contained
S. aureus and contaminating microorganisms.
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