肺部感染-影像学和病理.ppt

Outline
流行病学
影像学
病理学
细菌性-大叶性肺炎
病原菌：Streptococcus pneumoniae ，CAP(35%),     Klebsiella pneumoniae    Legionella pneumophila
病理生理：如下图
early (A) and advanced (B) stages of lobar pneumonia caused by Streptococcus pneumoniae. In (A), the airspaces are filled with edema fluid; only occasional neutrophils are evident. In (B), neutrophils predominate.
细菌性-小叶性肺炎
病原菌：Staphylococcus aureus    Escherichia coli    Pseudomonas aeruginosa    Anaerobes    Haemophilus influenzae
病理生理：

A:病原菌到达细支气管形成小叶中心结节和分枝斑片 B，C:支气管周围实变，小叶或部分小叶分布，呈多中心，实变不跨国小叶间裂
Acute bronchopneumonia. Low magnification photomicrograph shows several small foci of consolidation located around the lumens of small bronchioles (arrows).
Chest radiograph shows
areas of consolidation in
the right upper and left
lower lobes. The patient
was a 23-year-old man
With bronchopneumonia
High-resolution computed tomography (CT) scan shows centrilobular nodules (arrows) and lobular areas of consolidation (arrowhead) and ground-glass opacity (curved arrow). The patient was a 53-year-old man with bronchopneumonia.
并发症-肺脓肿
病原菌：anaerobic bacteria ，S. aureus, P. aeruginosa, and K. pneumoniae
Inflammatory mass with central purulent necrosisFrequently cavitateSmooth or shaggy inner marginsAir-liquid levels commonMaximal wall thickness usually <15Low-attenuation central region and rim enhancement on CT scan