Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
characteristics (and mode of deposition) appear to be quite different.
It has been suggested by some that this hyaline material represents an
imperfectly formed fibrin which has formed a jelly-like clot, not having
the property of developing the usual threads.
It is of importance to appreciate that the deposition of these hyaline
structures indicates a severe injury of the alveolar walls not commonly
observed in ordinary pneumonias.
In different areas of the same lung these constituents of the early
exudate may be observed in all proportions of admixture. Each one of the
elements of the exudate may largely overshadow the others and
prominently modify the appearance of the lesions. Broadly speaking,
however, the inflammatory œdema and hemorrhage occupying the greatest
part of the exudate in the lungs and the absence of marked leucocytic
response as well as the absence of the characteristic fibrinous meshwork
in the alveoli give to the early influenza-pneumonia a character
different from those which we ordinarily see.
It is during this early phase of the reaction that the influenza bacilli
can be shown within the lung structures. The distribution of bacteria is
not uniform. Clusters of these minute bacilli are found in the alveoli
at irregular intervals, many of the air sacs containing much exudate
being quite free from organisms. When present the bacteria appeared in
tightly aggregated schools lying free amongst cells of the exudate, but
also certain numbers being incorporated within the large mononuclear
cells. In some regions organisms of the type of the influenza bacilli
were alone seen, while elsewhere again, and particularly where the
exudate was assuming purulent characters other bacteria of the nature of
streptococci, staphylococci and micrococcus catarrhalis, were also
found.
_Lung—Secondary Stage_
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