Text A. Lobular PneumoniaPatient Sm

Text A. Lobular Pneumonia

Patient Smirnov aged 48 was admitted to the hospital with the diagnosis of lobular pneumonia. He had been developing lobular pneumonia gradually. A week before the admission to the hospital he had had bronchitis after which his condition did not improve.

Fever had an irregular course and the temperature changes were caused by the appearance of the new foci of inflammation in the pulmonary tissue. Fever had been persisting for two weeks and had been decreasing gradually.

The patient’s breathing was rapid with 30-40 respirations per minute. There was breathlessness and cyanosis of the face associated with the accompanying bronchitis, decrease in the respiratory surface and occlusion of numerous bronchioles and alveoli.

The patient complained of the pain in the chest particularly on deep breathing in and cough with purulent sputum. The pulse rate was accelerated and the arterial pressure was reduced.

On physical examination dullness in the left lung, abnormal respiration, numerous rales and crepitation were revealed. Dry rales caused by diffuse bronchitis were heard all over the lungs. The liver and spleen were not enlarged. The examination of the organs of the alimentary tract failed to reveal any abnormal signs but the tongue was coated.

The blood analysis revealed leucocytosis in the range of 12,000 to 15,000 per cu mm of blood and an accelerated erythrocyte sedimentation rate (ESR).

The urine contained a small amount of protein and erythrocytes. The X-ray examination of the lungs revealed numerous foci of inflammation of various size, irregular form and different intensity. Shadowing was particularly marked at the root of the left lung due to the enlargement of the lymphatic glands.

It was a severe form of lobular pneumonia which was difficult to differentiate from pulmonary tuberculosis and pleurisy. Yet the physician made a correct diagnosis.

Результаты (узбекский) 1:

Matn A. lobüler Pnevmoniya

48 yoshdan Bemor Smirnov lobüler pnevmoniya tashxisini bilan kasalxonaga qabul qilindi. U asta-sekin lobüler pnevmoniya rivojlanayotgan edi. U uning ahvoli yaxshi emas edi, shundan so'ng bronxit bor edi kasalxonaga qabul oldin bir hafta.

Isitma nosimmetrik, kursni edi va harorat o'zgarishlar o'pka to'qimasida yallig'lanish yangi o'choqlari paydo sabab bo'ldi. Isitma ikki hafta davom edi va asta-sekin kamayib edi.

Bemorning nafas minutiga 30-40 Respirations bilan tez edi. Nafas va hamrohlik bronxit bilan bog'liq yuzining siyanoz yo'q edi, nafas olish yuzaga kamaytirish va ko'plab bronşiyollerin va alveolalar g'ov.

Sabr ayniqsa yiringli balg'am bilan chuqur nafas va yo'tal haqida ko'krak og'riq shikoyat qildi. Yurak urish tezligi jadal edi va arterial bosim qisqartirildi.

Chap o'pka jismoniy imtihon bema'nilik, g'ayritabiiy nafas olish kuni ko'plab ral va g'archillash aniqlandi. Diffuz bronxit oqibatida quruq ral barcha o'pka orqali eshitildi. Jigar va taloq kattalashadi emas edi. Me'da-ichak yo'li organlarining ekspertiza har qanday g'ayritabiiy oyatlarini oshkor olmadi, lekin tili bilan qoplangan edi.

Qon tahlil qon Cu mm boshiga 15,000 12,000 oralig'ida lökositoz nozil va jadal eroziya tezligi (ESR).

Siydik oqsil va eritrotsitlar oz miqdorda mavjud. O'pka X-ray imtihon turli hajmi, tartibsizlik shakli va turli zichlik yallig'lanish ko'plab qaratishimiz zarur nozil. Gölgelenme ayniqsa tufayli limfa bezlari kengaytirish uchun chap o'pka ildizi da belgilangan edi.

Bu o'pka sili va plörezi dan farqlash qiyin edi lobüler pnevmoniya shiddatli shakli edi. Biroq shifokor to'g'ri tashxis qo'yishdi.