课件：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) 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 in a premature infant。 left）The l