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Lobar Pneumonia
• What is it??– It is a form of pneumonia that affects a large and
continuous area of the lobe of the lung– It is one of the two anatomic classifications of
pneumonia (the other being bronchopneumonia).
Lobar Pneumonia
• Symptoms: Usually has an acute progress which can be divided into 4 stages:– Congestion in the first 24 hours– Red hepatisation or consolidation– Grey Hepatisation– Resolution
Lobar Pneumonia
• Bacterial Causes:– Streptococcus pneumoniae (Most common cause) – Mycoplasma – Gram negative organisms – Legionella
Role of X-Ray
• Pneumonia is suspected on the basis of a patient's symptoms and findings from physical examination
• To help confirm the diagnosis usually a chest X-Ray is ordered.
• Chest x-rays can reveal areas of opacity which represent consolidation.
• Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. (alveolar space that contains liquid instead of gas.)
Role of X-ray
• Infiltrates can be divided in to alveoli and interstitial.– Alveloli infiltrate have Ill defined margins, a fluffy
apearance, patchy densities, which coalesce• Bacterial pneumonia affects lobe & lobule producing
alveolar infiltrate
– Infiltrates outside the sac: can be at interstitium, septum or at the framework • In Viral pneumonia has interstitial pattern initially
Lung Infiltrates
Acinar (usually from bacteria)• varying in size• indistinct edges• larger, hazy margins, cotton
wool
Interstitial (Viral)• same size• sharp edges• smaller densities
• In pneumonia, depending upon the amount and distribution of the airspaces involved, may present as confluent parenchymal (lobar or segmental) opacity or merely patchy opacity.
• Air bronchograms would also confirm an alveolar process.