肺部感染-影像学和病理.ppt

Empyema due to Staphylococcus aureus. The patient was a 44-year-old man and an intravenous drug user. He had no radiologic evidence of septic embolism. Septic embolism due to Staphylococcus aureus . The patient was a 43-year-old man with positive blood cultures for Staphylococcus aureus. 克雷白肺炎 CAP占1%-5%，HAP占15% 危险因素：嗜酒，慢性支气管肺病，ICU病人 常见影像学表现： CAP:均一大叶实变(右肺上叶多见） HAP:多中心单侧（60%），双侧（40%）实变（小叶性肺炎） 其他常见发现 叶间裂膨出（30%），胸腔积液（60-70%），肺脓肿，脓胸 CT价值：明确空腔或脓肿 Autopsied lung with severe pneumonia in a patient with degenerative neuronal Disorder。Numerous large and long pathogens are dispersed within the edematous alveolar space. The pathogens are not phagocytized by neutrophils (HE, low power). Lobar pneumonia due to Klebsiella pneumoniae. The patient was a 73-year-old woman with K. pneumoniae pneumonia. Klebsiella pneumoniae pneumonia and abscess formation 。The patient was a 53-year-old man .C ,D(3 days later) * 肺部感染-影像学和病理 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. 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