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Bronchopneumonia

Bronchopneumonia

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Encyclopedia
Bronchopneumonia or bronchial pneumonia or "Bronchogenic pneumonia" (not to be confused with lobar pneumonia
Lobar pneumonia
Lobar pneumonia is a form of pneumonia that affects a large and continuous area of the lobe of a lung.It is one of the two anatomic classifications of pneumonia .- Symptoms :...

) is the acute inflammation of the walls of the bronchiole
Bronchiole
The bronchioles or bronchioli are the first airway branches that no longer contain cartilage or glands in their submucosa. They are branches of the bronchi.The bronchioles terminate by entering the circular sacs called alveoli.- Structure :...

s. It is a type of pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

 characterized by multiple foci of isolated, acute consolidation, affecting one or more pulmonary lobules.

It is one of two types of bacterial pneumonia
Bacterial pneumonia
Bacterial pneumonia is a type of pneumonia caused by bacterial infection.-Sign and symptoms:*Fever*Rigors*Cough*Dyspnea*Chest pain*Pneumococcal pneumonia can cause Hemoptysis-Gram positive:...

 as classified by gross anatomic distribution of consolidation (solidification), the other being lobar pneumonia
Lobar pneumonia
Lobar pneumonia is a form of pneumonia that affects a large and continuous area of the lobe of a lung.It is one of the two anatomic classifications of pneumonia .- Symptoms :...

.

Associated conditions


Bronchopneumonia is less likely than lobar pneumonia to be associated with Streptococcus
Streptococcus
Streptococcus is a genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes and the lactic acid bacteria group. Cellular division occurs along a single axis in these bacteria, and thus they grow in chains or pairs, hence the name — from Greek στρεπτος streptos, meaning...

.

The bronchopneumonia pattern has been associated with hospital-acquired pneumonia
Hospital-acquired pneumonia
Hospital-acquired pneumonia or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48–72 hours after being admitted. It is usually caused by a bacterial infection, rather than a virus....

, and with specific organisms such as Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus is a facultative anaerobic Gram-positive coccal bacterium. It is frequently found as part of the normal skin flora on the skin and nasal passages. It is estimated that 20% of the human population are long-term carriers of S. aureus. S. aureus is the most common species of...

, Klebsiella
Klebsiella
Klebsiella is a genus of non-motile, Gram-negative, oxidase-negative, rod-shaped bacteria with a prominent polysaccharide-based capsule. It is named after the German microbiologist Edwin Klebs...

, E. coli, and Pseudomonas
Pseudomonas
Pseudomonas is a genus of gammaproteobacteria, belonging to the family Pseudomonadaceae containing 191 validly described species.Recently, 16S rRNA sequence analysis has redefined the taxonomy of many bacterial species. As a result, the genus Pseudomonas includes strains formerly classified in the...

.

In bacterial pneumonia, invasion of the lung parenchyma
Parenchyma
Parenchyma is a term used to describe a bulk of a substance. It is used in different ways in animals and in plants.The term is New Latin, f. Greek παρέγχυμα - parenkhuma, "visceral flesh", f. παρεγχεῖν - parenkhein, "to pour in" f. para-, "beside" + en-, "in" + khein, "to pour"...

 by bacteria produces an inflammatory
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

 immune response. This response leads to a filling of the alveolar sacs with exudate
Exudate
An exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation. It can apply to plants as well as animals. Its composition varies but generally includes water and the dissolved solutes of the main circulatory fluid such as sap or blood...

. 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.

Although these two patterns of pneumonia, lobar and lobular, are the classic anatomic categories of bacterial pneumonia
Bacterial pneumonia
Bacterial pneumonia is a type of pneumonia caused by bacterial infection.-Sign and symptoms:*Fever*Rigors*Cough*Dyspnea*Chest pain*Pneumococcal pneumonia can cause Hemoptysis-Gram positive:...

, 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.

Pathology


Macroscopically: Multiple foci
Focus (geometry)
In geometry, the foci are a pair of special points with reference to which any of a variety of curves is constructed. For example, foci can be used in defining conic sections, the four types of which are the circle, ellipse, parabola, and hyperbola...

 of consolidation are present in the basal lobes of the human lung
Human lung
The human lungs are the organs of respiration in humans. Humans have two lungs, with the left being divided into two lobes and the right into three lobes. Together, the lungs contain approximately of airways and 300 to 500 million alveoli, having a total surface area of about in...

, often bilateral. These lesions are 2-4 cm in diameter, grey-yellow, dry, often centered on a bronchiole
Bronchiole
The bronchioles or bronchioli are the first airway branches that no longer contain cartilage or glands in their submucosa. They are branches of the bronchi.The bronchioles terminate by entering the circular sacs called alveoli.- Structure :...

, are poorly delimited and have the tendency to confluence, especially in children.

Microscopically: A focus of inflammatory condensation is centered on a bronchiole
Bronchiole
The bronchioles or bronchioli are the first airway branches that no longer contain cartilage or glands in their submucosa. They are branches of the bronchi.The bronchioles terminate by entering the circular sacs called alveoli.- Structure :...

 with acute bronchiolitis (suppurative exudate - pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...

 - in the lumen
Lumen (anatomy)
A lumen in biology is the inside space of a tubular structure, such as an artery or intestine...

 and parietal inflammation). Alveolar lumens surrounding the bronchiole are filled with neutrophils ("leukocytic alveolitis"). Massive congestion is present. Inflammatory foci are separated by normal, aerated parenchyma.

Deaths


Freddie Mercury
Freddie Mercury
Freddie Mercury was a British musician, singer and songwriter, best known as the lead vocalist of the rock band Queen. As a performer, he was known for his flamboyant stage persona and powerful vocals over a four-octave range...

, the lead vocalist of the rock band Queen, died on 24 November 1991 because of Bronchopneumonia resulted from AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...



Actor Gregory Peck
Gregory Peck
Eldred Gregory Peck was an American actor.One of 20th Century Fox's most popular film stars from the 1940s to the 1960s, Peck continued to play important roles well into the 1980s. His notable performances include that of Atticus Finch in the 1962 film To Kill a Mockingbird, for which he won an...

died on June 12, 2003 of Bronchopneumonia

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