Spherical pneumonia

Introduction to spherical pneumonia An isolated round pneumonia called pneumonia (sphericalpneumonia) is a pneumonia named after the appearance of X-ray films. basic knowledge The proportion of illness: 0.098% Susceptible people: no specific population Mode of infection: non-infectious Complications: sepsis, septic shock, myocarditis, arrhythmia

Spherical pneumonia

(1) Causes of the disease

A scholar reported that only 3 cases of pathogens (Streptococcus pneumoniae, Hafnia and E. coli) were obtained after repeated investigations.

(two) pathogenesis

It is not yet clear that one case is that the patient's immune function is low, leading to external infections, especially bacterial infections. It is also said that the patient's immune function is acceptable, and the invading infection is quickly surrounded and limited, resulting in spherical pneumonia. There are many underlying diseases, and the lesions are mostly in the posterior segment of the upper lobe and the dorsal segment of the inferior lobe, and there is also inhalation through the airway.

For other pneumonia, the pathology of spherical pneumonia is inflammatory exudation and edema, which is caused by the centrifugal diffusion of alveoli to the periphery.

Spherical pneumonia prevention

Avoid the rain, cold, fatigue, drunkenness and other predisposing factors.

For susceptible populations, the pneumococcal vaccine can be injected. In the 1920s, the Streptococcus pneumoniae vaccine was used. It was abandoned due to the rise of antibiotics. With the increase of drug-resistant bacteria, vaccination has been revived for more than a decade. Attention is paid to the use of a multi-type combination of purified capsular antigen vaccines. Currently, there are commercially available vaccines containing 23 antigens in the specific polysaccharide antigen of Streptococcus pneumoniae, covering 85% to 90% of infections caused by Streptococcus pneumoniae. Although the level of precise protection is not well understood, because it is usually not possible to determine the antibody titer, it is generally believed that antibodies are present in the serum 2 to 3 weeks after the injection of the pneumococcal vaccine in healthy people, and the antibody titer continues to increase in 4 to 8 weeks. It can reduce the incidence of pneumococcal pneumonia, the effective rate is more than 50%, the period of protection is at least 1 year, for high-risk groups, repeated vaccination after 5 to 10 years.

Suitable for vaccination populations are children and adults over 2 years old who are susceptible to Streptococcus pneumoniae, including the elderly over 65 years old, patients with chronic cardiopulmonary disease, spleen insufficiency or spleen, Hodgkin's disease, multiple myeloma, diabetes, Cirrhosis, renal failure, HIV infection, organ transplantation and other immunosuppression-related diseases, repeated upper respiratory infections including otitis media and sinusitis are generally not considered to be indications for vaccination. About half of the vaccination occurs at the injection site. Erythema and/or pain, 1% fever, myalgia or local obvious reaction, 5% allergic or other obvious reaction, repeated vaccination within 5 years is prone to strong local reactions.

Spherical pneumonia complications Complications sepsis septic shock myocarditis arrhythmia

Severe sepsis can be complicated by septic shock or even ARDS, with high fever, but also does not rise in body temperature, blood pressure drops, cold limbs, sweating, cyanosis of the lips, and arrhythmia in myocarditis, such as premature contraction, paroxysmal tachycardia Or atrial fibrillation, chest X-ray examination can be found in about 25% of patients with pleural effusion, but only about 1% of empyema, after extensive use of antibiotics, empyema is rare, individual patients in the alveolar fibrin absorption is incomplete, and even Fibroblasts are formed, fibrosis, and organizing pneumonia.

Spherical pneumonia symptoms Common symptoms Rust color chest pain Chest pain

The clinical features of this disease are: most patients have acute inflammation, such as fever, cough, cough, elevated white blood cells and accelerated erythrocyte sedimentation rate, and more complicated with basic diseases. In addition to the above clinical manifestations, there are cases in Lee's case. Ten cases of chest pain (47.6%), 7 cases of blood stasis (33.3%), rust-colored sputum in cases of Markov et al, and 4 cases of blood in sputum, Japan reported that there were upper respiratory tract infections a few weeks ago. History is a feature, and the patient's symptoms are mild, hidden, and shoulder pain is another characteristic. Once a patient had a history of "cold", taking medication on the way, having a cough, a history of left shoulder pain, and filming the left upper spherical shadow. I was diagnosed with lung cancer, and I was ready for surgery. I had a routine chest X-ray examination 1 day before surgery. The lesion disappeared because I was treated with oral cephalosporin No. 4 after taking X-ray film and CT for about two weeks before the operation.

Examination of spherical pneumonia

Increased white blood cells and accelerated erythrocyte sedimentation rate.

Spherical lesions and low-density shadows were more common, most lesions were blurred, no lobulation and burr signs; hilar lymph nodes were not enlarged; tomography showed that the contour of the lesion was unclear, and most patients had longer lesions around the lesion and in the hilar direction. Cable-like shadows, and the so-called "local congestion signs" suggest that the mass is inflammation.

Diagnosis and diagnosis of spherical pneumonia

Differential diagnosis

Rose cultured 17 cases of nasopharyngeal secretions, 9 cases of pneumococci, 21 cases of Lee's, repeated investigation and culture, and only 3 cases of pathogenic bacteria (Streptococcus pneumoniae, Hafnia and E. coli), Therefore, it is not easy to diagnose, and it is important to rule out the diagnosis.

As mentioned above, the most important differential diagnosis is with lung cancer, or, more specifically, peripheral lung cancer. The smaller the lung cancer, the more peripheral it is, the less the lobes, burrs, and pleural traction signs of malignant lesions are. Confused with spherical pneumonia, some people think that more than half of the edge of the spherical lesion on the chest radiograph is blurred by pneumonia. On the contrary, most of the lung cancer has clear edges.

In addition, pulmonary embolism has recently been found more and more. Some people have summarized that the peripheral lesions are usually seen as "wedge shadows", and many of them are spherical or round, which needs attention.

Most of the typical pneumonia lesions disappeared within 1 to 2 weeks. Some people counted that 67.4% of large-leaf pneumonia lesions were absorbed within 18 days. Lslael et al. thought that 87% of pneumonia can be absorbed within 4 weeks, and normal absorption for more than 4 weeks is called Delayed absorption, more than 8 weeks for incomplete absorption, spherical pneumonia, regardless of the location of the lesion, or pathogenic, and the big leaf pneumonia is different, most authors agree to try to identify all aspects within 1 to 2 months Diagnosis, on the one hand, active anti-infective treatment (including anti-tuberculosis treatment), dissipating the prolonged lesions is a disturbing problem. The author sees spherical lesions that have been absorbed for up to half a year. Because the patient is timid, he refuses surgery many times and then heals himself. Of course, taking the medicine many times, all of them were suspended due to invalidity.

CT and percutaneous lung biopsy provide an effective means for the diagnosis of spherical lesions. CT is more accurate in density, marginal, bronchography, etc. Murata et al. studied high-resolution CT (HRCT) before and after spherical pneumonia absorption. Performance, that this test is helpful for differential diagnosis, the inflammation is even inside, small tumors are uneven due to degeneration, especially squamous cell carcinoma, and small peripheral tumors are closely related to blood vessels, but have little relationship with inflammation. Some people think that inflammation is not Involved in more than two related blood vessels, and some said that inflammation is almost independent of the pulmonary veins. In 3 cases of Murata, there are many arteries and veins introduced. After the disappearance of the shadow, the "vascular shadow" disappears and returns to the original state. There is proximal bronchiectasis, thickening of the bronchial wall, incomplete imaging of nearby blood vessels, and dysplasia of bronchovascular bundles around the foci, which are helpful for diagnosis. Percutaneous lung puncture for most lesions, for the vast majority Cancerous lesions can be diagnosed and should be widely explained to the society in order to obtain the cooperation of patients to avoid misdiagnosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.