Difference Between Lobar Pneumonia and Bronchopneumonia

January 2022 · 5 minute read

Key Difference – Lobar Pneumonia vs Bronchopneumonia
 

Invasion of the lung parenchyma by a disease-causing agent (mostly bacteria) evokes exudative solidification of the (consolidation) of the pulmonary tissue known as pneumonia. According to the localization of the inflammatory foci, pneumonia is divided into two main subcategories as lobar pneumonia and bronchopneumonia. When the infection is confined to only one or few lobes of lungs that is known as lobar pneumonia. On the other hand, bronchopneumonia is the inflammation of lung parenchyma that arises from bronchi or bronchioles secondary to an infection. Accordingly, the key difference between the two forms is that in lobar pneumonia, the inflammation is confined to one lobe but in bronchopneumonia inflammatory foci are present throughout the lungs without any localization. 

CONTENTS

1. Overview and Key Difference
2. What is Pneumonia
3. What is Lobar Pneumonia
4. What is Bronchopneumonia
5. Similarities Between Lobar Pneumonia and Bronchopneumonia
6. Side by Side Comparison – Lobar Pneumonia vs Bronchopneumonia in Tabular Form
7. Summary

What is Pneumonia?

The invasion of the lung parenchyma by a disease-causing agent, mostly bacteria evokes exudative solidification of the (consolidation) of the pulmonary tissue known as pneumonia.

Classification of pneumonia is based on several criteria.

  • With relation to the causative agent-Bacterial, viral, fungal
  • With relation to the gross anatomic distribution of the disease-Lobar Pneumonia, Bronchopneumonia
  • With relation to the place where the pneumonia is acquired-Community-acquired, hospital-acquired
  • With relation to the nature of the host reaction-Suppurative, fibrinous
  • Pathogenesis

    The normal lung is devoid of any disease-causing organisms or substances. The respiratory tract has several defense mechanisms aimed at preventing the entry of these disease-causing agents.

    Pneumonia can result whenever these defenses are impaired, or the host resistance is decreased. Factors such as chronic diseases, immuno suppression and use of immunosuppressive drugs, leukopenia, and viral infections affect the host resistance making the host vulnerable to get this kind of disorders.

    The clearance mechanisms can be damaged in several ways,

    Secondary to coma, anesthesia or neuromuscular diseases.

    Chronic smoking is the major reason for the destruction of the mucociliary apparatus.

    What is Lobar Pneumonia?

    When the infection is confined to only one or few lobes of lungs that is known as lobar pneumonia.Main causative agents are pneumococci, klebsiella, staphylococci, streptococci.

    Morphology

    Four stages of inflammatory response have classically been described.

    The lung is heavy, boggy, and red.This stage is characterized by vascular engorgement, intra -alveolar fluid with few neutrophils, and often the presence of numerous bacteria.

    Congestion is followed by red hepatization that is characterized by massive confluent exudation with red cells, neutrophils, and fibrin filling the alveolar spaces.

    In the gray hepatization stage because of the progressive disintegration of the red blood cells that have accumulated in the alveolar spaces, lungs assume a gray color. This grayish appearance is enhanced by the presence of the fibrino suppurative exudate.

    During the final stage of the pathogenesis, the consolidated exudate that has accumulated within the alveolar spaces undergoes progressive enzymatic digestion to produce granular semi-fluid debris that is reabsorbed and ingested by macrophages or coughed up.

    Complications

    Clinical Features

    Investigations

    Difference Between Lobar Pneumonia and Bronchopneumonia

    Figure 01: Chest x-ray appearance in Lobar Pneumonia

    Management

    Empirical antibiotic therapy can be started after taking the samples for investigations. The prescribed antibiotics are subjected changes when the antibiotic sensitivity test and culture results are available. Ventilatory support should be given to the patients with severe breathing difficulties.

    What is Bronchopneumonia?

    Bronchopneumonia is the inflammation of lung parenchyma that arises from bronchi or bronchioles secondary to an infection. Staphylococci, Streptococci, Pneumococci, Haemophilus, and Pseudomonas auregenosa are the main causative agents.

    Key Difference Between Lobar Pneumonia and Bronchopneumonia

    Figure 02: An infected lung with Bronchopneumonia

    Morphology

    What are the Similarities Between Lobar Pneumonia and Bronchopneumonia?

    What is the Difference Between Lobar Pneumonia and Bronchopneumonia?

    Lobar Pneumonia vs Bronchopneumonia

    When the infection is confined to only one or few lobes of lungs that is known as lobar pneumonia.Bronchopneumonia is the inflammation of lung parenchyma which arises from bronchi or bronchioles secondary to an infection.
     Causative Agents
    Main causative agents are pneumococci, klebsiella, staphylococci, streptococci.Staphylococci, Streptococci, Pneumococci, Haemophilus, and Pseudomonas auregenosa are the main causative agents.
    Impact of the Inflammation
    Inflammation is confined to one or more lobes.Inflammation is not localized, and there are multiple inflammatory foci.

    Summary – Lobar Pneumonia vs Bronchopneumonia

    When the infection is confined to only one or few lobes of lungs that is known as lobar pneumonia. Bronchopneumonia is the inflammation of lung parenchyma that arises from bronchi or bronchioles secondary to an infection.As given in their definitions, lobar pneumonia is confined to one or few lobes, but bronchopneumonia affects a wide area of the lungs without any localization.

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    Reference:

    1.Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders.

    Image Courtesy:

    1.’PneumonisWedge09’By James Heilman, MD – Own work, (CC BY-SA 3.0) via Commons Wikimedia  
    2.’Bronchopneumonia lung’By Yale Rosen (CC BY-SA 2.0) via Commons Wikimedia

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