Few RBCs, raisede neutrophils with some hemorrhage in alveoli is seen in: March 2005

Ans. B: Red hepatizationAll 4 phases may be seen in different pas of the same lung.Congestion (1-2 days)Red hepatization (2nd-4th day)Gray hepatization (4th-6th day)Resolution ( 8th-9th day)In the earliest stage of pneumococcal pneumonia, protein-rich edema fluid containing numerous organisms (Streptococcus pneumoniae) fills the alveoli. Marked congestion of the capillaries is typical.Sholy after this congestion occurs there is a massive outpouring of polymorphonuclear leukocytes accompanied by intra-alveolar hemorrhage. Many of the red blood cells undergo lysis. These cells, together with polymprphonuclearleukocytes, produce the rusty sputum.Because the firm consistency of the affected lung is reminiscent of the liver, this stage has been named "red hepatization". The next phase, occurring after 2 or more days, depending on the success of treatment, involves the lysis of polymorphonuclear leukocytes and the appearance of macrophages, which phagocytose the fragmented polymorphonuclear leukocytes and other inflammatory debris.The lung is now no longer congested but still remains firm in this stage of "gray hepatization".The alveolar exudates is then removed and the lung gradually returns to normal.