IPLab:Lab 3:Lobar Pneumonia

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Clinical Summary[edit]

This 41-year-old black male was brought to the hospital in a comatose state. The patient, who had a history of heavy alcohol intake, was found comatose on the morning of the day of admission. No further history is available.

On admission, the pertinent findings included a temperature of 104°, a white cell count of 22,700 cells/mm³, nuchal rigidity, elevated spinal fluid pressure, and the presence of Gram-positive diplococci on a smear of spinal fluid (cultures of blood and spinal fluid were subsequently reported positive for Streptococcus pneumoniae). The patient expired 12 hours after admission in spite of intensive antibiotic therapy.

Autopsy Findings[edit]

The right lung weighed 800 grams. The most striking finding was a marked uniform consolidation of the entire middle lobe which was reddish-gray in color. There was also marked thickening of the pleura overlying the middle lobe.

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Related IPLab Cases[edit]

A normal white blood cell count is 4,000 to 11,000 cells per cubic mm.

Nuchal rigidity is stiffness of the neck, a common sign of meningeal irritation.

CNS infections can lead to increased intracranial pressure, which, if severe, can cause death.

The normal weight of the right lung in an adult is 450 grams (range: 360 to 570 grams).

In alcoholics, aspiration pneumonia is common--bacteria enter the lung via aspiration of gastric contents.

An infiltrate is an accumulation of cells in the lung parenchyma--this is a sign of pneumonia.