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
MacCallum[69] states that the following types of pneumonia following
influenza may be recognized. 1. Pneumococcus pneumonia. The lobular
character of the consolidation is in these cases well marked, although
it tends to lose its definiteness through the confluence of adjacent
areas. The cut surface of the lung shows in the more acute cases a
peculiar lobular or confluent consolidation which corresponds well with
what is commonly written of the stage of engorgement in the description
of lobar pneumonia. Later stages in the pneumonia show within these
areas patches of rough gray consolidated tissue from which definite
plugs of exudate project. 2. Staphylococcal pneumonia. 3. Streptococcal
pneumonia. There is lobular pneumonia, the interlobular septa are
edematous and, microscopically, bronchi and alveoli are loaded with
streptococci. Whole areas of lung, though retaining their form, are
entirely necrotic. Lymphatics are distended with exudate containing
streptococci in great numbers, but in none of these cases is
interstitial bronchopneumonia found. 4. Pneumonia produced by B.
influenzæ of Pfeiffer. The lung is studded with palpable shot-like
grayish yellow nodules; the bronchi exude thick yellow pus, which
contains influenza bacilli. Microscopically, the walls of the bronchi
are found to be thickened by mononuclear infiltration and new formation
of connective tissue. The walls of the alveoli are thickened and
indurated and the alveoli often contain fibrin in process of
organization. Absence of conspicuous changes in lymphatics, absence of
intense pleural infection and relatively scant numbers of polynuclear
leucocytes in the exudate within the alveoli and bronchial walls are,
MacCallum states, all that distinguish this pulmonary change from the
interstitial bronchopneumonia caused by the hemolytic streptococcus and
described by him in previous papers.
Lyon[70] designates the pulmonary lesion following influenza,
hemorrhagic pneumonitis, the lung tissue containing serous fluid loaded
with red blood corpuscles; in many instances there was such scant
consolidation that the process could not be regarded as a true
pneumonia. In 35 instances the lesion was lobular in distribution and in
16 instances was sufficiently extensive to be designated lobar, but it
was not typical lobar pneumonia, and, often associated with lobular
patches of consolidation, appeared to be a confluent lobular pneumonia.
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