Abstract:
:The causes and pathogenesis of severe childhood pneumonia in a developing country were studied in lungs removed at autopsy from 119 Bangladeshi children who presented with pneumonia and/or diarrhea. Pneumonia was observed in 93 patients. Morphologic features included acute alveolar exudate in 51% (of the 93 patients), necrotizing pneumonia in 31%, interstitial pneumonia in 22%, and caseating granulomas in 4%, while a mixed pattern occurred in 16% of patients. Causes of pneumonia were Gram-negative bacteria in 27%, pneumococcus in 8%, cytomegalovirus (CMV) in 8%, Pneumocystis carinii (PC) in 4%, mycobacteria in 3%, aspergillus in 3%, mixed anaerobes in 3%, viral (not CMV) in 2%, Staphylococcus aureus in 1% and ascaris in 1%. Two causative agents were identified in 7% of patients. In 46% of the cases, no etiologic agent was identified. Our data suggest that most pneumonias had a bacterial etiology; however, viruses, including CMV, and other opportunistic organisms such as PC, were also important pathogens. Gram-negative pneumonia was partially attributed to concomitant intestinal infections. Opportunistic infections resulted from malnutrition and debilitated host defenses during prolonged fatal illnesses.
journal_name
Pathologyjournal_title
Pathologyauthors
Tomashefski JF Jr,Butler T,Islam Mdoi
10.3109/00313028909059538subject
Has Abstractpub_date
1989-04-01 00:00:00pages
71-8issue
2eissn
0031-3025issn
1465-3931journal_volume
21pub_type
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