肺部感染-影像学和病理_PPT课件.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) * 大肠埃希氏菌肺炎 CAP(4%), HAP 的5-20% 危险因素：操劳过度病人 常见影像学表现：多中心单侧或双侧实变（支气管肺炎），下叶为主 其他表现：胸腔积液 * Bronchopneumonia due to Escherichia coli .Chest radiograph shows poorly defined nodular opacities (arrows) in the right upper lobe and small bilateral foci of consolidation. * 铜绿假单胞菌肺炎 HAP占20% 危险因素：COPD,机械通气，抗生素运用，囊型纤维化定植菌 常见影像学表现：小叶性肺炎，所有肺叶受累，CT提示小叶中心结节和tree-in-bud 其他常见表现：肺脓肿（20%），胸腔积液（60%） * 左上，右上:Perivascular cuffing 征， 左下：美兰细菌染色。右下：痰图片染色（胶质铁染色） * 痰染色 左：胶质铁染色 右：革兰染色 * Severe pneumonia due to Pseudomonas. * 流感嗜血杆菌肺炎 5-20%的CAP病原菌 危险因素：COPD,嗜酒，高龄 常见影像学表现：小叶性肺炎（50-60%）大叶性肺炎（30-40%） 非常见表现：CT示小结节和树芽征，圆肺炎，空洞（不超过15%），胸腔积液（50%） * 图左：Neonatal pneumonia caused by Haemophilus influenzae infection 图右：阳性痰涂片 * Bronchiolitis and bronchopneumonia due to Haemophilus influenza . The patient was a 50-year-old man with H. influenza pneumonia. * 军团菌肺炎 2-5%CAP 危险因素：高龄，男性，肿瘤或器官移植 主要影像学表现：大叶性肺炎，进展至多叶受累 少见表现：球形实变（圆肺炎），单个或多个结节或者肿块样实变 并发症：空洞（免疫抑制病人），肺门淋巴结肿大(免疫抑制病人），胸腔积液（35-60%） * Fatal hospital-acquired pneumonia seen i