Jump to navigation Jump to search

WikiDoc Resources for Bronchopneumonia


Most recent articles on Bronchopneumonia

Most cited articles on Bronchopneumonia

Review articles on Bronchopneumonia

Articles on Bronchopneumonia in N Eng J Med, Lancet, BMJ


Powerpoint slides on Bronchopneumonia

Images of Bronchopneumonia

Photos of Bronchopneumonia

Podcasts & MP3s on Bronchopneumonia

Videos on Bronchopneumonia

Evidence Based Medicine

Cochrane Collaboration on Bronchopneumonia

Bandolier on Bronchopneumonia

TRIP on Bronchopneumonia

Clinical Trials

Ongoing Trials on Bronchopneumonia at Clinical

Trial results on Bronchopneumonia

Clinical Trials on Bronchopneumonia at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Bronchopneumonia

NICE Guidance on Bronchopneumonia


FDA on Bronchopneumonia

CDC on Bronchopneumonia


Books on Bronchopneumonia


Bronchopneumonia in the news

Be alerted to news on Bronchopneumonia

News trends on Bronchopneumonia


Blogs on Bronchopneumonia


Definitions of Bronchopneumonia

Patient Resources / Community

Patient resources on Bronchopneumonia

Discussion groups on Bronchopneumonia

Patient Handouts on Bronchopneumonia

Directions to Hospitals Treating Bronchopneumonia

Risk calculators and risk factors for Bronchopneumonia

Healthcare Provider Resources

Symptoms of Bronchopneumonia

Causes & Risk Factors for Bronchopneumonia

Diagnostic studies for Bronchopneumonia

Treatment of Bronchopneumonia

Continuing Medical Education (CME)

CME Programs on Bronchopneumonia


Bronchopneumonia en Espanol

Bronchopneumonia en Francais


Bronchopneumonia in the Marketplace

Patents on Bronchopneumonia

Experimental / Informatics

List of terms related to Bronchopneumonia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Historical Perspective

  • Pneumonia was first recognized by Hippocrates. It was first identified and described by Laennec in 1819.
  • In 1842, Rokitansky differentiated Pneumonia into Bronchopneumonia and Lobar Pneumonia.


  • Pneumonia may be classified according to anatomic distribution of consolidation into two subtypes/groups:
    • Lobar
    • Lobular (Bronchopneumonia)


  • The pathogenesis of Bronchopneumonia is characterized by inflammation of lung parenchyma.
  • On gross pathology, multiple foci of consolidation is a characteristic feature of Bronchopneumonia. They are present bilaterally, most commonly in the basal lobes. These lesions are 2-4 cm in diameter, grey-yellow, dry, often centered by a bronchia, are poorly delimited and have the tendency to confluence, especially in children.
  • On microscopic histopathological analysis, a focus of inflammatory condensation, centered by a bronchiola with acute bronchiolitis is a characteristic finding in Bronchopneumonia. In addition, alveolar lumens surrounding the bronchia are filled with neutrophils and suppurative exudate("leukocytic alveolitis"), massive congestion is present and inflammatory foci are separated by normal, aerated parenchyma.
  • Bronchopneumonia is most commonly caused by pneumococcal serotypes 3, 7,8,10,18 and 20.
  • Common mechanisms in development of pneumonia include, micro-aspiration, hematogenous spread, spread from a contiguous focus and macro-aspiration.
  • Bronchopneumonia is usually associated with infections due to gram-negative bacteria, Staphylococcus aureus and some fungi.

Clinical Features

  • Common clinical findings in Bronchopneumonia include cough, fever, chills, dyspnea, pleuritic chest pain and sputum production. However, many of these features may be absent in older patients.
  • Bronchopneumonia can also case Gastrointestinal symptoms such as nausea, vomiting and diarrhea.
  • Older patients may also present with altered mental status.

Differentiating Bronchopneumonia from other Diseases

  • Lobular pneumonia must be differentiated from other diseases that cause similar clinical symptoms and interstitial infiltrates on chest x-ray such as:

Epidemiology and Demographics

  • The rate of Community acquired pneumonia is approximately 5.16-7.06 cases per 1000 individuals per year.

Age[edit | edit source]

  • Patients of all age groups may develop Bronchopneumonia.
  • Bronchopneumonia is more commonly observed among elderly patients.

Gender[edit | edit source]

  • Brochopneumonia is more commonly observed in men than women.

Race[edit | edit source]

  • Bronchopneumonia is more commonly observed in Black persons than caucasians.

Risk Factors

  • Common risk factors in the development of Bronchopneumonia are Influenza infection, Alcohol abuse, Hyposplenism/splenectomy, smoking, COPD/Asthma and Immunocompromise. Additional risk factors include, homelessness, incarceration, pregnancy, crack cocaine use, opioid use and occupational welding.
  • Risk factors for a complicated course include, older age, preexisting lung condition, immunodeficiency/AIDS, and acquisition of a nosocomial infection.

Natural History, Complications and Prognosis


Diagnostic Study of choice

  • The diagnosis is made when clinical and radiological evidence suggests the presence of Bronchopneumonia.


Physical Examination

  • Physical examination may be remarkable for:

Laboratory Findings

  • There are no specific laboratory findings associated with Bronchopneumonia.
  • A leukocytosis (15000-30000 per mm3) with a left ward shift on a blood test can aid in diagnosis of Bronchopneumonia.
  • An elevated concentration of ESR or CRP is a non-specific indication of inflammation in the body.

Imaging Findings

  • Chest x-ray is the imaging modality of choice for Bronchopneumonia.
  • On chest x-ray, Bronchopneumonia is characterized by peribronchial thickening and poorly defined air-space opacities. Inhomogeneous patchy areas of consolidation involving several lobes reflect more severe disease. When confluent, bronchopneumonia may resemble lobar pneumonia.
  • In the case of a negative chest x-ray and a high clinical suspicion, HRCT scan may be used to confirm the diagnosis as it has a higher sensitivity and accuracy in detecting lesions and anatomical changes.
Bronchopneumonia Case courtesy of Dr Henry Knipe, <a href=""></a>. From the case <a href="">rID: 49869</a>
  • In case of emergency where chest x-ray and HRCT cannot be performed, lung ultrasound performed by an experienced physician can yield findings.

Other Diagnostic Studies

  • Microbial analysis in Bronchopneumonia can be performed using techniques such as Blood culture, Sputum analysis, PCR and Urine antigen detection, however, pathogens are not commonly identified and empiric treatment should be started once the diagnosis is made.[2]


Medical Therapy

  • The mainstay of therapy for Bronchopneumonia is antibiotics and supportive care.
  • Choice of antibiotics is dependent on epidemiology of microbes, resistance and patients' co-morbidities and severity of illness.
  • In patients without co-morbidities Macrolides such as Azithromycin and Clarithromycin can be used. In the case of Macrolide resistant pneumonias and patients with multiple co-morbidities, Doxycycline, Amoxicillin-Clavulanate, and Cephalosporins such as Cefpodoxime and Cefuroxime may be used.
  • Response to antibiotics can be monitored with clinical improvement, serum inflammatory markers and chest x-ray findings. However, most non-complicated pneumonias are treated out-patient and only require two follow up treatments to clinically determine improvement and resolution of the pneumonia, respectively. Follow-up chest x-rays are only required in male patients over the age of 50 years and smokers.


  • Effective measures for the primary prevention of Bronchopneumonia include vaccination against influenza and pneumococcal antigens, and smoking cessation. Pneumococcal vaccination is indicated in patients over the age of 65 years.

External links

Template:Respiratory pathology



  1. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (March 2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clin. Infect. Dis. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083.