chart summaries for infections 1-4 - wenlu Flashcards
What diseases are associated with Acute Suppurative Inflammation?
Acute Bacterial Pneumonia
Endocarditis
Pyelonephritis
Abdominal Abscess / Appendicitis
What diseases are associated with…
- Mononuclear Inflammation?
- Granulomatous Inflammation?
- Chronic Inflammation and Scaring?
- Mononuclear Inflammation»_space; Salmonella typhi
- Granulomatous Inflammation»_space; M tuberculosis
- Chronic Inflammation and Scaring»_space; Lung Abscess and Empyema; Schistosomiasis
What diseases are associated with Cytophathic/Cyotproliferative Inflammation?
Influenza
Measles Pneumonia
Cytomegalovirus
What illnesses are associated with Necrotizing Inflammation?
Amoebic Dysentery
Pseudomembranous Colitis
What illnesses are associated with “Little Inflammation?”
Cryptococcal Meningitis
Malaria
What illness and inflammation type is Streptococcus pneumoniae associated with?
Acute Bacterial Pnuemonia
Acute Suppurative Inflammation
What are the mechanisms that cause disease with Streptococcus Pneumoniae?
- has a polysaccharide capsule that prevents phagocytosis
- secretes IgA protease with inactivates IgAs
- has a proinflammatory cell wall that induces TNF and IL-1
What does the proinflammatory cell wall of Streptococcus Pneumoniae induce?
TNF and IL-1
Other than pneumonia, what illnesses can Streptococcus Pneumoniae cause?
Pneumonia
Bacteremia
Meningitis
What is the pattern of cellular response to Streptococcus pneumoniae or in any Acute Bacterial Pneumonia with Acute Suppurative Inflammation?
- PMNs recruited
- Edema
- Acute inflammation: PMNs, Platelets, Complement and Coagulation
- Consolidation of the lungs: tissue becomes red/grey hepatization
- Resolution: macrophage clean up
- Lobar pneumonia mid lung
What illness and inflammation is caused by Stapylococcus Aureus?
Endocarditis
Acute suppurative inflammation
What is the mechanism of pathogenesis for S. Aureus to cause endocarditis?
- Bacteria deposit on fibrin on valve
2. Local destruction of tissue with PMN infiltrate
What is the pattern of cellular response to S. Aureus in Endocarditis?
- Vegetations (bacterial)
- Inflammatory lesion may erode into valve ring»_space; hemodynamic decompensation»_space;> death
Note: there are four types of “Vegetations,” including Rheumatic, infectious, Non-bacterial, and Autoimmune
What type of Kidney disease and inflammation does E. Coli cause?
What type of bacteria is E coli?
Pyelonephritis
Acute suppurative inflammation
Enteric Gram neg rod
What are the two categorical origins of pyelonehritis?
Ascending pyelonephritis (from UTI) Bacteremia from blood and glomerulus
What is the mechanism of ascending pyelonephritis?
- adherence of E. coli to the urinary epithelium
- Colonization of the urethra
- Ascending UTIs
What are the cellular responses to pyelonephritis?
- Ascending UTI
- Suppurative infammation in the interstitial and renal tubules
- Papillary necrosis, pyelonephrosis, perinephric abscess
What kind of bacteria cause appendicitis?
mixed bacterial populations with various virulence factors that promot abscess formation
What type of inflammation is appendicitis?
Acute Suppurative Inflammation
Why are abdominal abscesses (ex: appendicitis) difficult to treat with drugs? with endogenous immunity?
- With abdominal abscesses, there is an inactivation or lack of diffusion of antibiotics to the center of the abscess
- No cell surface of ECM for PMN migration to occur
What is the pattern of cellular response to abdominal abscesses (ex: appendicitis) in acute suppurative inflammation?
- Full necrosis of bowel wall
2. Peritoneal inflammation
What type of inflammation does Salmonella typhi cause?
Mononuclear inflammation
What type of microoganism is S. typhi?
What are its virulence factors?
Intracellular Gram neg bacillus
Endotoxin
Antigens
How does Salmonella typhi invade humans?
- fecal oral transmission
2. Invades monocyte-macrophage cells where it produces endotoxin and antigens
What are characteristics and steps of infection of Typhoid fever?
Bacteremia
ucleration
bleeding in the bowels
risk of bowel perforation
disseminated infection can lead to osteomyelitis
Note: there is no subacute illness. If S. typhi is present, you get sick
What is the pattern of cellular response in mononuclear inflammation with S. Typhi?
- Mononuclear (macrophage/lymphocyte) inflammation in Peyer’s patches in intestines, liver, and spleen.
- Nodules of aggregated mononuclear cells with intracellular bacteria
- Typhoid fever = classic sign = rose spots on the abdomen
What kind of inflammation does Mycobacterium Tuberculosis cause?
Granulomatous Inflammation
What are signature qualities of Mycobacterium Tuberculosis that cause inflammation?
(individual questions follow)
Acid-fast
Aerobic intracellular bacteria
Glycolipid factors induce granulomas
Lipoarabinomanan (which is similar to LPS) inhibits macrophage activation
Does Mycobacterium tuberculosis bind to acid?
Yes.
Acid fast = M. tuberculosis
What is lipoarabinomanan?
the M tuberculosis equivalent to LPS
It inhibits macrophage activation, thereby escaping destruction.
What are the steps in pathogenesis for M. Tuberculosis?
- taken into macrophages
- multiply in non-acidified phagosomes
- delayed-type hypersensitivity (CD4 stimulates TNF-alpha and IFN-gamma)
- macrophage activation and granuloma formation
What is the pattern of cellular response for M. tuberculosis in granulomatous inflammation?
- granuloma formation
- caseation necrosis
- liquifaction
- tissue destruction and hemorrhage
Are Lung Abscesses and Empyema caused by aerobic or anaerobic bacteria?
Both
Mixed aerobic/anaerobic bacteria are associated with upper respiratory flora
What type of Inflammation and response are caused by lung abscesses and empyema?
Chronic Inflammation and Scarring
What are the mechanisms of pathogenesis for Lung Abscesses and Empyema?
- Bacteria in respiratory tract
2. Recruitment of macrophages, lymphocytes, and plasma cells
What are the cellular responses to Lung Abscesses and Empyema?
- Acute suppurative inflammation plus tissue destruction = walled off fibrous cavity with liquified central cavity
- macrophages, lymphocytes, and plasma cells around areas of bacterial growth
- resolution by drainage through bronchus
- scaring, restriction of lung capacity
What kind of inflammation does Schistomiasis cause?
Chronic Inflammation and Scarring
What is the life cycle of Schistomiasis?
- People urinate Schistomiasis eggs
- Eggs grow and infect snails
- Change form to infect humans through skin
- Travel into blood stream and mate for life in mesenteric veins
- Eggs are pathogenic
What cells and cell signals are involved in Schistomiasis pathogenesis?
Eosinophil infiltrate, granulomas, dense fibrosis.
IL 4, IL 5, and IL 13 are involved
Over time the acute response becomes chronic
What is the pattern of cellular and systemic responses to Schistomiasis?
What type of cancer can occur?
- Pipe-stem fibrosis/scarring of the liver (note: liver cells outside of fibrosis are still intact)
- Portal hypertension
- Ascites
- Hematuria
- Promotion of squamous cell carcinoma of the bladder
What inflammatory response occurs with influenza?
Cytopathic/Cytoproliferative
What type of virus is flu?
What are its main antigens?
RNA virus with genetic recombination and antigenic variation
Hemaglutanin and Neuraminidase
What is the mechanism of pathogenesis for influenza?
Wet aerosol droplets (TB can be dry)
Hemagluttinin fuses virus to host cell
Neuraminidase allows the virus to uncoat
What is the pattern of cellular response to influenza in cytopathic/cytoproliferative inflammation?
What are primary and secondary effects?
- Localized necrosis of respiratory epithelium, systemic symptoms
- Primary Viral Pneumonia – edema, necrosis of ciliated epitheium, lymphocytic infiltrates in submucosa
- Secondary Bacterial pneumonia – acute suppurative inflammation, S. aureus often pathogen
What bacteria is common to create a secondary pneumonia from influenza?
Staphylococcus Aureus
What do the lungs look like with influenza pneumonia?
fluffy, dispersed, not lobular
What type of inflammation does CMV cause?
Cytopathic/Cytoproliferative
What type of virus is CMV?
DNA herpes virus
Opportunistic
What is the pathogenesis of CMV?
Infection of epithelial and endothelial cells (lungs, liver, kidney, CNS, retina)
Can have latent infection
What is the pattern of cellular response to CMV?
Large intranuclear inclusion within enlarged cells
Pneumonia, focal necrosis of many organs, ulceration of intestine
“Owls eye” nucleus
What kind of inflammation is caused by Amoebic Dystentery?
Necrotizing
What are the characteristics of Ameobic Dysentery that cause disease?
Protozoan with infectious cyst, invasive trophozoite
Surface lectin – adhere to colonic epithelium, invasion, complement resistance
What is the mechanism of pathogenesis for Ameobic Dysentery?
Oral infection by cyst
Become trophozoites in intestine and migrate to colon
Trophozoites kill PMNs, liquefy tissues to make “sterile abscesses”
Travel to other organs (liver, lungs, etc.) or make more cysts
What is the the pattern of cellular response to Ameobic Dystentery Necrotizing Inflammation?
Colitis with “flask-shaped” ulcers
No PMNs
Ulcer, sometimes to base of submucosa, sometimes rupture wall and result in peritonitis
What type of inflammation does Pseudomembranous Colitis cause?
Necrotizing
What are the characteristics of Pseudomembrenaous Colitis that cause disease?
What organism?
Clostridium difficile – gram (+), spore-forming, anaerobic bacillus
Cytotoxin A and B
What mechanism of pathogenesis is used by Clostridium Difficile?
- Colonization after disturbance of normal flora
- Produce cytotoxins – kill cells, mucosa
- Adherence of many material to cells
What kind of inflammation is caused by Cryptococcal Meningitis?
Little inflammation
What characteristics of Cryptococcal Meningitis cause disease?
Cryptococcus neoformans – encapsulated yeast found with nitrogenous soils, aerosol spread
Polysaccharide capsule – virulence
What mechanism of pathogenesis is used by Cryptococcal Meningitis?
Respiratory infection
Dissemination to meninges, bone, skin
Insidious and slow onset, chronic meningitis, hydrocephalus
What pattern of cellular response occurs with Cryptococcus neoformans with little inflammation?
No toxins, little acute inflammation
Yeast is eventually phagocytosed in lung macrophages
Eventual loose granuloma
“Apple jelly” gelatinous appearance in meninges
Turns tryptophan into melanin-like substance (brown)
What illness and inflammation is caused by Plasmodium Falciparum?
Malaria
Little inflammation
What mechanism of pathogenesis is used by Plasmodium Falciparum in malaria?
Mosquito bite injects parasite
Parasite infect RBCs, but matures in liver; parasite breaks out and infects more RBCs, lysis and repeat
Infected RBCs bind to endothelium
Local clogging of small vessels, release of cytokines
Organ dysfunction
What is the pattern of cellular response to Plasmodium falciparum?
Congestion and enlargement of spleen and liver
Deposition of malaria pigment from hemoglobin digestion
Ring hemorrhages in cerebral malaria
Little inflammatory infiltrate
