Bronchopneumonia

Bronchopneumonia

General Description Bronchopneumonia refers to a type of pneumonia that is localized, often to the bronchioles and surrounding alveoli. (Compare to lobar pneumonia below)

Clinical Signs
One or more of the following symptoms: coughing, chest pains, fever, blood-streaked sputum, chills, and difficulty in breathing.
Signs of pulmonary congestion

Pathophysiology Inhalation of organisms.
Scarring if alveoli destroyed.

Histopathology Patchy distribution in and around small airways
Dense acute inflammatory exudate of PMNs, fibrin and blood in bronchi, bronchioles and adjacent alveoli.
FOCAL destruction of alveolar walls (you can see normal parenchyma in other areas adjacent)
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