Bronkopneumoni

Bronkopneumoni, or bronchopneumonia, is a pattern of pneumonia characterized by patchy, confluent areas of alveolar inflammation that originate around the bronchi and bronchioles and often affect multiple lobes or both lungs. It is not a single disease but a descriptive radiologic and pathologic pattern caused by various pathogens.

Causes and risk factors: It can be bacterial, viral, or mixed. Common bacterial causes include Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae, and less commonly Streptococcus pneumoniae and Gram-negative bacteria. Viruses such as influenza or respiratory syncytial virus can predispose. Aspiration of oropharyngeal contents, especially in the elderly, debilitated, or neurologically impaired, is a frequent cause. The pattern is more common in young children, older adults, and those with hospitalization or immunosuppression.

Clinical presentation: Symptoms typically include fever, productive cough, and shortness of breath. Examination may reveal crackles or rhonchi, often basilar and bilateral.

Diagnosis: Chest radiographs show patchy air-space infiltrates around the bronchi, frequently bilateral. CT is reserved for uncertain cases. Microbiologic testing (sputum culture, blood cultures in severe disease) can help identify the pathogen. Laboratory tests may show leukocytosis or other findings depending on age and comorbidity.

Management and prognosis: Treatment depends on setting and likely pathogens. Community-acquired bronchopneumonia is treated with antibiotics covering common bacteria; hospital-acquired cases require broader-spectrum therapy. Most patients improve with treatment, but complications such as lung abscess, empyema, or pleural effusion can occur, especially in older or sicker individuals.

Prevention: Vaccination against pneumococcus and influenza, aspiration risk reduction, and infection control in healthcare settings.