PATHOLOGY OF THE LUNGS IN CHILDHOOD MALNUTRITION IN JAMAICA - LIGHT AND ELECTRON-MICROSCOPY

The autopsy records of 115 children with severe protein-energy malnutr ition were reviewed Sections of the lung histology showed evidence of bacterial pneumonia in 49% of cases. An additional 18% showed bronchit is, bronchiolitis or interstitial pneumonitis. Aspiration of gastric c ontents was evident in 10% of cases; 6% showed pulmonary oedema and co ngestion. In the remaining cases, no lung pathology-was identified (17 %). In 8 cases, rapid autopsy examination permitted fixation of lung t issue for electron microscopy. These included 4 cases of bronchopneumo nia, one of which was associated with viral pneumonia. Another interst itial pneumonitis, probably of viral aetiology, was also studied Both these virus-associated cases showed loss of type I pneumocytes and hyp erplasia of type II pneumocytes. Another patient with herpes simplex h epatitis showed necrotic emboli in pulmonary capillaries with virions, as well as colonies of interstitial bacteria. One patient with acute pulmonary oedema displayed severe endothelial cell swelling on electro n microscopy. In one case, there was no evidence of respiratory change s, apart from desquamation of type I pneumocytes. Useful information c an be obtained on the fine structure of the lung, using samples taken soon after death.