Bronchopneumonia

What is Bronchopneumonia ?

Bronchopneumonia is a illness of lung which is caused by different organism like bacteria, viruses, and fungi and characterized by acute inflammation of the walls of the bronchioles. It is also known as pneumonia. It is common in women and causes to the 6% deaths.

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.

What are Causes of Bronchopneumonia ?

Bacterial pneumonias tend to be the most serious and, in adults, the most common cause of pneumonia. Streptococcus pneumoniae (pneumococcus) and Mycoplasma pneumoniae both are the common bacterium which which causes bronchopneumonia in the adults and children. The most common pneumonia-causing bacterium in adults is Streptococcus pneumoniae (pneumococcus).

Pathology

• Inhalation of organisms.
• Scarring if alveoli destroyed.

Multiple foci of consolidation are present in the basal lobes, often bilateral. 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.

A focus of inflammatory condensation is centered by a bronchiola with acute bronchiolitis (suppurative exudate - pus - in the lumen and parietal inflammation). Alveolar lumens surrounding the bronchia are filled with neutrophils ("leukocytic alveolitis"). Massive congestion is present. Inflammatory foci are separated by normal, aerated parenchyma.

What are the Symptoms ?

• Cough with greenish or yellow mucus
• Fever
• chest pain
• Rapid, shallow breathing
• Shortness of breath
• Headache
• Loss of appetite
• Fatigue
• Blood-streaked sputum
• Chills
• Signs of pulmonary congestion

Comparison of Bronchopneumonia vs. Lobar Pneumonia

	Bronchopneumonia	Lobar Pneumonia
Location	1. often bilateral 2. basal (i.e. lower lobes)	large area, even whole lobe involvement
Route of infection	spreads from bronchioles to nearby alveoli	both alveoli and bronchioles
Spread of infection	consolidation is patchy	Whole lobe becomes consolidated
Susceptible group	infants, elderly	Adults especially alcoholics and vagrants.
Causing Organism	Dependent on circumstances predisposing to infection(i.e. nosocomial or community acquired)	Often caused by Pneumococcus or Klebsiella.
Recovery	If treated, recovery usually involves focal organisation of lung by fibrosis.	If treated promptly, many recover with lungs returning to normal structure and functioning by resolution. In other cases the exudate in alveoli is organised, leading to lung scarring and permanent lung dysfunction.
Notes	Patients who are immobile develop retention of secretions; thus, most commonly involves the lower lobes.	Patient are severely ill and usually associated bacteriemia.

Treatment of bronchopneumonia

If the cause is bacterial, the goal is to cure the infection with antibiotics. If the cause is viral, antibiotics will nbot e effective. In some cases it is difficult to distinguish between viral and bacterial pneumonia, so antibiotics may be prescribed. Pneumococcal vaccinations are recommended for individuals in high-risk groups and provide up to 80 percent effectiveness in staving off pneumococcal pneumonia. Influenza vaccinations are also frequently of use in decreasing one’s susceptibility to pneumonia, since the flu precedes pneumonia development in many cases.