Pulmonary lesion
The pathogenesis of the pulmonary lesions are described:
- it is suggested that bacteria adhere more easily to the abnormal epithelium and that mucus cannot be efficiently cleared
- chronic bacterial infection results in mucus gland hypertrophy, mucus hypersecretion and further infection
- the bronchial wall is damaged and bronchiectasis develops
- when established bronchiectasis is present and mucociliary transport is compromised, then clearance of the lungs is increasingly dependent on gravity and cough
- principal pathogens include:
- Haemophilus influenzae
- Staphylococcus aureus
- later, Pseudomonas aeruginosa and other pseudomonads
- small areas of parenchymal consolidation and fibrosis may develop as a result of impaired clearance
- in advanced disease there is increasing destruction of lung tissue and emphysema
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