Bronchopneumonia
| Bronchopneumonia | |
| ICD-10 | J18.0 |
|---|---|
| ICD-9 | 485 |
| MeSH | D001996 |
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Overview[edit | edit source]
Bronchopneumonia (Lobular pneumonia) - is one of two types of bacterial pneumonia as classified by gross anatomic distribution of consolidation (solidification). In bacterial pneumonia, invasion of the lung parenchyma by bacteria produces an inflammatory immune response. This response leads to a filling of the alveolar sacs with exudate. The loss of air space and its replacement with fluid is called consolidation. In bronchopneumonia, or lobular pneumonia, there are multiple foci of isolated, acute consolidation, affecting one or more pulmonary lobes.
It should be noted that although these two patterns of pneumonia, lobar and lobular, are the classic anatomic categories of bacterial pneumonia, in clinical practice the types are difficult to apply, as the patterns usually overlap. Bronchopneumonia (lobular) often leads to lobar pneumonia as the infection progresses. The same organism may cause one type of pneumonia in one patient, and another in a different patient. From the clinical standpoint, far more important than distinguishing the anatomical subtype of pneumonia, is identifying its causative agent and accurately assessing the extent of the disease.
Historical Perspective[edit | edit source]
- Pneumonia was first recognized by Hippocrates. It was first identified and described by Laennec in 1819.
- In 1842, Rokitansky differentiated Pneumonia into Bronchopneumonia and Lobar Pneumonia.
Classification[edit | edit source]
- Pneumonia may be classified according to anatomic distribution of consolidation into two subtypes/groups:
- Lobar
- Lobular (Bronchopneumonia)
Pathophysiology[edit | edit source]
- The pathogenesis of Bronchopneumonia is characterized by inflammation of lung parenchyma.
- On gross pathology, multiple foci of consolidation is a characteristic feature of Bronchopneumonia. They are present bilaterally, most commonly in the basal lobes. These lesions are 2-4 cm in diameter, grey-yellow, dry, often centered by a bronchia, are poorly delimited and have the tendency to confluence, especially in children.
- On microscopic histopathological analysis, a focus of inflammatory condensation, centered by a bronchiola with acute bronchiolitis is a characteristic finding in Bronchopneumonia. In addition, alveolar lumens surrounding the bronchia are filled with neutrophils and suppurative exudate("leukocytic alveolitis"), massive congestion is present and inflammatory foci are separated by normal, aerated parenchyma..
Clinical Features[edit | edit source]
Differentiating [disease name] from other Diseases[edit | edit source]
- [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
- [Differential dx1]
- [Differential dx2]
- [Differential dx3]
Epidemiology and Demographics[edit | edit source]
- The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
- In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
Age[edit | edit source]
- Patients of all age groups may develop Bronchopneumonia.
- [Disease name] is more commonly observed among patients aged [age range] years old.
- [Disease name] is more commonly observed among [elderly patients/young patients/children].
Gender[edit | edit source]
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected with [disease name] than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race[edit | edit source]
- There is no racial predilection for [disease name].
- [Disease name] usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop [disease name].
Risk Factors[edit | edit source]
- Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis[edit | edit source]
- Early clinical features include sudden fever, [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of Bronchopneumonia include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
Diagnosis[edit | edit source]
Diagnostic Criteria[edit | edit source]
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms[edit | edit source]
- Symptoms of Bronchopneumonia may include the following:
- Fever
- Chills
- Cough
- Chest Pain
- Shortness of breath
Physical Examination[edit | edit source]
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings[edit | edit source]
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings[edit | edit source]
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies[edit | edit source]
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment[edit | edit source]
Medical Therapy[edit | edit source]
- The mainstay of therapy for Bronchopneumonia is antibiotics and supportive care.
- [Medical therapy 1] acts by [mechanism of action 1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery[edit | edit source]
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention[edit | edit source]
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References[edit | edit source]
- Abbas, Abul K, Kumar, Vinay and Fausto, Nelson. Robbins and Coltran Pathologic Basis of Disease, 7th ed. Philadelphia: Elsevier Saunders, 2005.