The Curious Clinicians

71 - Slow to Resolve

Jun 1, 2023
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INSIGHT

Slow Resolution of Pneumonia

  • Pneumonia infiltrates can take weeks to resolve on chest x-rays, even after symptoms improve.
  • The organism causing the pneumonia influences the resolution speed, with Legionella and bacteremic pneumococcal pneumonia being the slowest.
INSIGHT

Composition of Early Pneumonia Infiltrates

  • Early pneumonia infiltrates (days 1-4) consist of neutrophils, edema, fibrin, and red blood cells, essentially pus.
  • This inflammatory response explains why corticosteroids might help in severe pneumonia cases.
INSIGHT

Shift in Immune Cells

  • Around day five, bacteria are usually gone, and neutrophils are no longer the primary immune cell.
  • Macrophages become the dominant cell type, initiating the cleanup process.
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