Hospital therapy. Pneumonia. Etiology, pathogenesis, classification (most important)

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Hospital therapy. Pneumonia. Etiology, pathogenesis, classification (most important)

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31. Pneumonia. Etiology, pathogenesis, classification

Pneumonia is an acute infectious and inflammatory disease of a focal nature, in which the respiratory sections and interstitial connective tissue of the lungs are involved in the pathological process.

Classification by E. V. Gembitsky (1983).

By etiology:

1) bacterial (indicating the pathogen);

2) viral (indicating the pathogen);

3) cornitic;

4) rickettsial;

5) mycoplasma;

6) fungal;

7) mixed;

8) infectious-allergic;

9) unknown etiology.

By pathogenesis:

1) primary;

2) secondary.

Clinical and morphological characteristics:

1) parenchymal: croupous; focal;

2) interstitial.

By localization and extent: unilateral; bilateral. By severity: extremely severe; heavy; moderate; mild and abortive. Downstream: sharp; protracted (radiological and clinical resolution of pneumonia).

Etiology. Most pneumonia is of infectious origin. Pneumonia allergic and caused by the action of physical or chemical factors are rare. Bacterial pneumonias are diagnosed more often in middle-aged and elderly people; viral pneumonia - in young people. In the etiology of primary bacterial pneumonia, the leading role belongs to pneumococci. During an influenza epidemic, the role of viral-bacterial associations (usually staphylococci), as well as opportunistic microorganisms, increases.

In secondary pneumonia, the leading etiological role is played by gram-negative bacteria (klebsiella pneumoniae and influenza bacillus); in the occurrence of aspiration pneumonia, the importance of anaerobic infection is great.

Pathogenesis. The infectious agent enters from the outside into the respiratory sections of the lungs through the bronchi: inhalation and aspiration (from the nasopharynx or oropharynx). By hematogenous route, the pathogen enters the lungs mainly in secondary pneumonia or in the thrombotic genesis of pneumonia. Lymphogenic spread of infection with the onset of pneumonia is observed only with injuries to the chest.

Significant importance in the pathogenesis of pneumonia is also attached to allergic and autoallergic reactions.

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