1. Background

• Bronchoscopic examination/biopsy reveals extensive areas of haemorrhagic necrosis, multiple abscesses, and irregular areas of cavitation. The pleural surface is usually covered by an extensive fibrinopurulent exudate.
• mortality is 10-30%

1. Prodrome

• upper respiratory tract infection (viral) for several days
• staphylococcal skin lesions may be present

2. Pneumonia

• sudden onset with rapid progression of symptoms
  • high fever
  • cough
  • respiratory distress -> arrest
  • toxic appearance - lethargic or irritable, shocky
• associated symptoms:
  • vomiting, anorexia, diarrhea
  • abdominal distension (due to ileus)

3. Complications

1. Chest X-Ray

• initally unilateral (or predominantly one-sided) bronchopneumonia (disseminated interstitial infiltration)
• rapid progression to patchy or dense and homogeneous involving an entire lobe or hemithorax
• righ lung involved (65%); bilateral (<20%)
• complications

2. Microbiology

• samples of sputum, throat swab, nasopharyngeal secretions, tracheal aspirate, bronchial washings, lung aspirate, pleural fluid
• others: blood, CSF, urine
• culture and rapid antigen detection

3. Serum

• leukocytosis (>20) with increased PMN's
• mild-to-moderate anemia

1. Medical

• Penicillin V or G for 3-4 weeks
• manage complications:
  • due to Staphylococcal infections
  • respiratory
• intubation/ventilation
• treat underlying illnesses