Atelectasis with Pneumonia

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Abstract
In an attempt to evaluate the mechanisms producing the marked decrease in pulmonary function and the tendency to atelectasis in pneumonia, the surface activity of extracts of lungs involved with pneumonia was investigated. Twenty-two of 23 pneumonic specimens demonstrated abnormal surface activity. Eleven of 19 grossly uninfected lobes on the same side were also abnormal, and 4 had evidence of atelectasis. Ten specimens from the opposite lungs were all normal. The results suggest an antagonist to the pulmonary surfactant present in infected portions of lung, which may diffuse into contiguous normal portions. The likelihood of this material being responsible for the atelectasis is stressed, and the possibility raised that it may also decrease pulmonary function. It appears that a considerable degree of surfactant deficiency may be present without producing alveolar collapse. It is speculated that the surfactant antagonist is a proteolytic enzyme produced either by the infecting organism or by the human host, possibly as a defense mechanism in an attempt to isolate the infection.

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