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Bronchopneumonia.

Bronchopneumonia, or focal pneumonia, is characterized by the development in the pulmonary parenchyma of foci of acute inflammation ranging in size from the acinus to the segment associated with the affected bronchiole. The development of the disease is preceded by inflammatory processes in the bronchi, which can be detected simultaneously with foci of bronchopneumonia. It is diagnosed in 2/3 of patients hospitalized for acute pneumonia. By pathogenesis it is often secondary, the etiology is diverse (see above).

The pathogenesis of bronchopneumonia is associated with the airborne spread of the pathogen and its aspiration from the upper respiratory tract, as well as hematogenous and less often contact ways.

A prerequisite for the development of bronchopneumonia is a violation of the drainage function of the bronchi, which can contribute to hypothermia, intoxication, anesthesia, etc. Violation of the drainage function of the bronchi facilitates the penetration of microorganisms into the respiratory departments of the lung - alveolar passages, alveoli. In this case, the defeat of the bronchi first occurs, and then the inflammatory process caused by microorganisms from the small bronchi and bronchioles extends to the adjacent alveoli. Usually, inflammation passes to the lung tissue in a descending way, intrabronchially. However, with the development of destructive bronchitis and bronchiolitis, the peri bronchial pathway is also possible. With a generalized infection (septicopyemia), a hematogenous pathway of the pathogen into the lungs is observed.

A special group of bronchopneumonia is composed of aspiration, hypostatic and postoperative pneumonia associated with activation of autoinfection.

In recent years, nosocomial acute pneumonia, including pneumonia in immunosuppressive patients, which in most cases are opportunistic infections, has attracted no less interest.

Pathological anatomy is largely determined by the type of pathogen, but there are also stereotypic changes characteristic of all types of bronchopneumonia. These include the formation of a focus of inflammation around the small bronchus and bronchiole with the phenomena of bronchitis and / or bronchiolitis, which is represented by various forms of catarrh (serous, mucous, purulent, mixed). Violation of the drainage function of the bronchi facilitates the penetration of pathogens into the respiratory parts of the lungs. In this case, inflammation extends to respiratory bronchioles and alveoli. The walls of the bronchioles are infiltrated by cells of the inflammatory infiltrate. In the gaps of the alveoli and bronchioles, as well as bronchi, exudate accumulates. The exudate can be serous, purulent, hemorrhagic, mixed in nature, which is largely determined by the etiology of the disease and the severity of the process. On the periphery of the foci, preserved lung tissue with the phenomena of perifocal emphysema is located.

Macroscopically, dense airless foci of various sizes are found, usually forming around the bronchi, the lumen of which is filled with liquid turbid contents of gray-red color, and localized, as a rule, in the posterior and posterior-lower segments of the lungs (2,6,8,9,10). Depending on the size of the foci, miliary, acinous, lobular, drain lobular, segmental and polysegmental bronchopneumonia are distinguished.

Morphological features of certain types of bronchopneumonia. Pneumococcus-induced bronchopneumonia is the most common etiological form of pneumonia. It is characterized by the formation of foci associated with bronchioles and containing fibrinous exudate. On the periphery of such foci, microbial edema is expressed, where a large number of pathogens are detected.

Bronchopneumonia caused by staphylococcus is extremely rare, in 5-10% of acute pneumonia. It can develop after pharyngitis, as well as as a complication after a viral infection (usually influenza). It has a morphology of typical bronchopneumonia with hemorrhagic and destructive bronchitis with a clear tendency to suppuration and necrosis of the alveolar septum. In connection with the latter, acute abscesses, purulent pleurisy, pneumocele, cysts, as well as severe fibrosis in the outcome of the disease, often develop.

Bronchopneumonia caused by streptococcus, accounts for 11-13% of acute pneumonia. It is usually caused by hemolytic steptococcus of groups A and B, often in combination with viruses, as well as in patients with diabetes mellitus. The defeat of the lower lobes is characteristic. Microscopic examination reveals foci of bronchopneumonia with serous-leukocyte exudate with a pronounced interstitial component. In some cases, acute abscesses and bronchiectasis occur. Often complicated by pleurisy.

Bronchopneumonia caused by Pseudomonas aeruginosa is one of the most frequent nosocomial acute pneumonia. Two options for the penetration of the pathogen into the lungs are described: by aspiration and through the blood. In the first case, bronchopneumonia develops with abscess formation and pleurisy. In the second - we are talking about patients with malignant tumors or extensive festering wounds, when bronchopneumonia occurs with severe coagulation necrosis and hemorrhagic component. The prognosis is poor. Mortality is 50%.

E. coli bronchopneumonia. Usually, the pathogen enters the lungs by the hematogenous route during infections of the urinary tract, gastrointestinal tract, and after surgical interventions. Pneumonia is often bilateral with the hemorrhagic nature of the exudate, foci of necrosis and abscess formation.

Mushroom-induced bronchopneumonia. More often caused by fungi of the genus Candida. Foci of pneumonia of various sizes with clusters of polymorphonuclear leukocytes and eosinophils, a tendency to the formation of decay cavities, where you can find the filament of the fungus. With hyperergic reactions, interstitial inflammation develops, followed by fibrosis.

Acute interstitial pneumonia (pneumonitis) is a disease of an infectious nature, characterized by the primary development of acute inflammation in the alveolar wall and pulmonary interstitium with possible secondary formation of exudate in the lumen of the alveoli and bronchioles. It is extremely rare. The etiology is associated with viruses, mycoplasma, fungi, pneumocystis.

A synonym for acute interstitial pneumonia is acute pneumonitis. The latter term is preferable and important for the practitioner, since it emphasizes the difference between this group of diseases and acute pneumonia, which determines the use of other methods of therapy.
Antibiotics for interstitial pneumonia are not recommended and can contribute to the aggravation of immunopathological processes and the progression of the disease.

Hamman and Rich described a disease of unknown nature, called Hamman-Rich disease. The disease has common clinical and morphological features with acute interstitial pneumonia, but it proceeds extremely rapidly with the progression of acute pulmonary heart disease and death within 2–4 months. The etiology of this disease has not yet been established, although the pathogenetic mechanisms of such a dramatic and rapid course are largely disclosed, and the morphology corresponds to damage to the interstitium of the respiratory parts of the lungs.

The pathogenesis of acute interstitial pneumonia is associated with primary damage to the pathogens of the elements of the alveolar wall - pneumocytes of the 1st and 2nd order, capillary endothelium, which is accompanied by the development of acute inflammation in this territory. Often, immunopathological mechanisms are involved in the process, such as immediate and delayed hypersensitivity reactions.

Morphological manifestations are largely stereotyped and are characterized by damage and regeneration of the alveolar epithelium, plethora of the alveolar capellaries, inflammatory infiltration of the alveolar wall, accumulation of protein fluid in the lumens of the alveoli, often with the formation of hyaline membranes, often with an admixture of polymorphonuclear leukocytes, and macrophi. In the outcome, interstitial fibrosis often develops.

Acute interstitial pneumonia caused by viruses. A variety of viral diseases (influenza, parainfluenza, adenovirus infections, etc.) are accompanied by the development of pneumonia of both viral and viral-bacterial nature (influenza pneumonia). Often, viral pneumonia occurs in childhood viral infections. A feature of viral interstitial pneumonia is the predominance of lymphohistiocytic elements in the inflammatory infiltrate in the interstitium, which is caused by reactions of cellular immunity, as well as the detection in some cases of characteristic intracellular inclusions (adenoviruses, cytomegaloviruses) and multinucleated cells (measles virus). Reliable verification of the etiological factor is carried out during an immunoluminescent study with antibodies to virus antigens.

Mycoplasma interstitial pneumonia. Mycoplasma pneumoniae is a common causative agent of upper respiratory tract infections. In cities, 15-25% of pneumonia is caused by this microorganism. Mostly sick children and adolescents, as well as adults over 45 years. The defeat is usually one-sided and spread over a certain territory. Generalization of infection with damage to other organs and systems is possible.

A microscopic examination reveals a picture of acute interstitial pneumonia with bronchiolitis and characteristic mononuclear infiltrate. During the SIC reaction and during Romanovsky – Giemsa staining in macrophages, one can see characteristic SEC positive inclusions, which are indirect confirmation of the presence of mycoplasma. A reliable method of verification of the pathogen is an immunohistochemical study with antibodies to mycoplasma antigens.

Pneumocystis interstitial pneumonia is detected in immunosuppressive patients with drug and viral immunosuppression. With HIV infection, it develops in approximately 75% of cases. The causative agent of Pneumocystis carini. The development of a diffuse, bilateral interstitial process with severe respiratory failure is characteristic. Microscopic examination - diffuse infiltration of the alveolar septa with an accumulation in the lumen of the alveoli of foamy SIR-positive eosinophilic material with strands of unpainted cysts (in some, basophilic sporozonts are visible). Specific is coloring by Grocott.

Acute interstitial pneumonia caused by L. pneumophilia (Legionnaires disease). The disease was described for the first time in 1970, when the epidemic of peculiar pneumonia among American legionaries in Philadelphia was first recorded. Of the 182 cases, 29 people died. The disease begins with a headache, muscle pain, dry cough. The causative agent does not stain according to Gram, antibodies enhance the phagocytosis of bacteria by macrophages, however, due to their ability to endocytobiosis in phagocytes, they can persist in the body for a long time. In the lungs, bronchopneumonia develops with the involvement of several lobes. In some cases, macroscopically, the lesion may resemble croupous pneumonia in the stage of gray hepatitis with the development of fibrinous pleurisy. Microscopic examination is characterized by hemorrhagic edema, infiltration of alveolar septa by macrophages and polymorphonuclear leukocytes.

Complications are largely determined by the etiology of the disease and the severity of its course. They can be divided into pulmonary and extrapulmonary and are presented with the same options as with croupous pneumonia. Among the pulmonary complications of bronchopneumonia, pleurisy should also be mentioned, which develops in cases where the focus of inflammation is located under the pleura.

The death of patients may be due to pneumonia itself, its purulent complications and pulmonary heart disease.

Lecture equipment

Macrodrugs: pulmonary embolism, pulmonary infarction, Wegener's granulomatosis, pulmonary atrophy in pulmonary hypertension, croupous pneumonia (stage of gray hepatitis), lung abscess, pleural empyema, purulent mediastenitis, purulent meningitis, brain abscess, endocarditis, bronchitis, endocarditis, endocarditis influenza pneumonia, bronchiectasis and pneumococcosis.

Micropreparations: pulmonary atelectasis, pulmonary edema, adult respiratory distress syndrome, pulmonary embolism, pulmonary infarction, Wegener's granulomatosis, pulmonary artery in pulmonary hypertension, croupous pneumonia (gray guardianship stage), lung carnification, purulent mycenitis, purulent mycophenia, meningitis pneumocystis pneumonia, influenza pneumonia, measles pneumonia, cytomegalovirus pneumonia, adenovirus pneumonia.

Electron diffraction patterns: fibrin resorption in croupous pneumonia.
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Bronchopneumonia.

  1. Bronchopneumonia (focal pneumonia)
    • It constitutes the bulk of acute pneumonia. • Polyethiological. The most common pathogens are bacteria: pneumococci, staphylococci, streptococci, Pseudomonas aeruginosa, etc. • May occur as a nosocomial infection in debilitated patients, usually caused by gram-negative microorganisms (Klebsiella, Pseudomonas aeruginosa and Escherichia coli) and Staphylococcus aureus. • more often
  2. Determination of the etiology of calf bronchopneumonia.
    Bronchopneumonia of calves is a polyetiological disease. According to V.M. Danilevsky (1985), Alikayev (1973, 1985), and other authors, bronchopneumonia is a disease of uninfected origin, the microbial factor in the development of nonspecific bronchopneumonia of calves is not leading and has no pathogenetic significance. Microorganisms isolated from the lungs of sick and dead animals
  3. Treatment of calves with bronchopneumonia.
    Treatment of sick animals must be carried out comprehensively with the selection of patients in separate groups depending on the course of the disease and its severity. The main condition for the successful treatment of bronchopneumonia is the elimination of etiological factors, the creation of optimal conditions of detention and ensuring complete feeding. Comprehensive treatment combined with well-organized conditions
  4. Normalization of cicatricial digestion in calves with bronchopneumonia
    Nizaeva A.I. Scientific adviser: Ph.D., assistant Kuzmina L.N. Federal State Educational Institution of Higher Professional Education Ural State Academy of Veterinary Medicine, Troitsk The development of animal husbandry and veterinary medicine is directly related to the development of systems for increasing animal productivity and protecting their health. For these purposes, various means and methods are used, including various biological additives, stimulants.
  5. Course work. Cost-effectiveness of therapeutic measures for calf bronchopneumonia, 2010
    Characteristics of the farm General information about the farm Natural and Climatic conditions Climate Relief Vegetation Main lines of activity Feeding and feeding system Analysis of the economic and financial activities of the enterprise Own research Characteristics of the activities of the veterinary service Veterinary documentation in the farm Literature review Concept of the disease
  6. The effectiveness of the treatment of catarrhal bronchopneumonia in piglets in the conditions of Prigorodnoye CJSC, Irbitsky District, Sverdlovsk Region
    Romanov A.V. Scientific adviser: Ph.D., Acting Associate Professor Kirsanova T.S. Federal State-Funded Educational Institution of Higher Professional Education “Ural State Academy of Veterinary Medicine”, Troitsk The cultivation of healthy young animals, their safety from diseases and death is one of the main tasks of animal husbandry. This is due to the fact that the incidence and death of young farm animals, as the least adapted to the conditions
  7. Pathomorphology and treatment of catarrhal bronchopneumonia in calves in the conditions of Prigorodnoye CJSC, Irbitsky District, Sverdlovsk Region, Sputnik Village
    Romanov A.V. Scientific advisers: Molokanova I.V., Ph.D. biol. N., Associate Professor Vet.Surgery and Pathomorphology, Desyatnik V.I., Assistant of the Department. Veterinary surgery and pathomorphology Federal State Educational Institution of Higher Professional Education “Ural State Academy of Veterinary Medicine”, Troitsk. Catarrhal bronchial pneumonia of the calves causes great economic damage, resulting from the death of calves, weight loss and average daily gains,
  8. Bacterial and viral airborne infections: influenza, parainfluenza, adenovirus infection, respiratory syncytial infection. Bacterial bronchopneumonia, lobar pneumonia.
    1. Supplement: Atelectasis of the lungs is _______________________. 2. The clinical and morphological form of bacterial pneumonia is determined by 1. the type of inflammation 3. the etiological agent 2. the affected area 4. the response of the body 3. In case of croupous pneumonia the consistency of the affected lobe 1. dense 2. flabby 3. not changed 4. The ability of the virus to selectively infect cells and tissues
  9. Tasks for the assignment Tasks. 1. True croup: Indicate the clinical and morphological variant of diphtheria in which true croup occurs. Indicate the localization of the process. What is the nature of the pathological process. List its possible complications: a) ..., b) ..., c) ... Standards of solutions. 1. True Croup: Respiratory Diphtheria. B. Larynx Exudative inflammation: fibrinous, croupous. a) asphyxia, b) bronchopneumonia, c) complications of tracheotomy and intubation (bedsores). 2. The first period of scarlet fever

  10. Disease concept
    Bronchopneumonia is a disease manifested by inflammation of the bronchi and lobes of the lung with accumulation in the alveoli of exudate and cells of the desquamated epithelium. The pathological process begins with the appearance in the lungs and pulmonary parenchyma of serous exudate, which corresponds to the picture of catarrhal pneumonia in adult animals, but since the bronchi are primarily affected and the process quickly
  11. Initial data for determining the economic efficiency of veterinary measures.
    In SEC "DIMITROVSKY" the most common respiratory diseases are bronchitis and bronchopneumonia. In particular, the following drugs are used to treat bronchopneumonia: nitox and tetravitis. Consider the damage caused to the au pair. 1. The cost of one calf at birth: Cn = 3.61 x C where, 3.61 is the amount of milk that can be obtained from feed,
  12. Clinical signs.
    Three forms of the disease are distinguished depending on the severity of the course of bronchopneumonia: The acute form of bronchopneumonia lasts 5-10 days. It starts with a slight malaise, lethargy, loss of appetite; only on 2-3 days of illness the temperature rises to 40-42 degrees / C. Shortness of breath occurs, and in severe cases, breathing with an open mouth. The conjunctiva is hyperemic in the same way as the mucosa
  13. Disease Prevention
    Prevention of bronchopneumonia consists of a complex of organizational, economic, zoohygienic and veterinary and sanitary measures aimed at obtaining and growing strong, disease-resistant young animals. Particular attention is paid to creating optimal conditions for keeping and feeding uterine livestock and young animals. Livestock buildings must meet approved
  14. Acute inflammatory lung diseases (pneumonia)
    Among acute pneumonia, there are croupous (lobar), having the nature of an independent disease, and focal bronchopneumonia as a manifestation or complication of another disease. Croupous pneumonia is an acute infectious and allergic disease in which fibrinous inflammation seizes the lobe of the lung (lobar or lobar pneumonia) and its pleura (pleuropneumonia). Morphologically during
  15. Pneumonia and their complications
    Pneumonia is pneumonia that occurs on its own or as a complication in other diseases. Pneumonia in dogs is relatively rare. The etiological classification of pneumonia was adopted, according to which bacterial pneumonia is distinguished - primary, lobar and secondary small focal bronchopneumonia, complicating the course of viral infections, as well as aspiration, thromboembolic,
  16. ACUTE INFLAMMATORY DISEASES OF THE LUNGS (PNEUMONIA)
    Acute pneumonia is a group of acute etiological, pathogenesis and morphological characteristics of acute infectious inflammatory diseases of the lungs with a primary lesion of the respiratory departments and the presence of intra-alveolar exudate. Most commonly caused by bacteria, mycoplasmas and viruses. According to clinical and morphological features, croupous (lobar) pneumonia is distinguished,
  17. Pathological changes.
    In most animals, in acute bronchopneumonia, pallor of the mucous membranes is found. The lung tissue is densified, in the apical and middle lobes there are multiple pneumonic foci from the surface and in the thickness of an organ with a diameter of one to several centimeters, blue-red or pale gray, dense, with a specific gravity heavier than water. When these foci are cut, it stands out
  18. Acute pneumonia
    - respiratory syndrome at the onset of the disease or in the process - toxicosis syndrome of 1-3 degrees in the course of the disease - bronchial obstructive syndrome of infectious genesis is possible with bronchopneumonia - respiratory failure syndrome of 1-4 degrees - bronchopulmonary syndrome: increased vocal trembling and bronchophony in a certain segment, there same shortening of percussion sound, there is also a change
  19. PIG CHlamydia
    Chlamydia of pigs (lat. - Chlamydiasis suum; English - Chlamydiosis of swine; enzootic abortion of pigs, chlamydia of pigs, chlamydial bronchopneumonia of pigs) - a chronic disease that causes abortion in sows in the second half of pregnancy, stillbirth, the birth of a non-viable offspring; у хряков — уретриты, у молодняка — пневмонии, реже поражения центральной нервной системы, энтериты,
  20. Диктиокаулезы жвачных
    Диктиокаулезы (dictyocauleses) – нематодозные заболевания животных, протекающие остро или хронически с признаками снижения аппетита, кашля и исхудания. Etiology. Возбудителями болезни являются гельминты из рода Dictyocaulus (D. filaria, D. viviparus). Первый вид длиной 30-100 мм паразитирует в легких овец, второй – 20-70 мм – в легких телят. Epizootology. Инвазионные личинки диктиокаул
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