Chronic Diseases and Infections

Question 0

Consider the role of infections in chronic health conditions with particular attention to Diabetes Mellitus

Answer 0

Diabetes Mellitus:
Hyperglycaemia and acidaemia impair humoral immunity and lymphocyte function
Micro/macro vascular disease –> poor tissue perfusion –> hypoxia –> infection
Neuropathy –> diminished sensation –> unnoticed skin
Malignant otitis externa (ENT) - pseudomonas aeruginosa, external auditory canal –> adjacent soft tissue/cartilage/bone
Rhinocerebral mucormycosis - mould fungi colonise nose and paranasal sinuses –> adjacent tissue = soft bone necrosis, bony erosion

Question 1

Consider the impact of chronic infections

Answer 1

Increased number of people with chronic illnesses living for longer
Successful management = management of infections

Question 2

Consider the role of infections in chronic health conditions with particular attention to Cystic Fibrosis

Answer 2

Autosomal recessive (1 in 25)
Defect in CFTR gene (phenylalanine deleted) in exocrine glands --> defect in Cl- transmembrane transport 
Dehydrated, viscous mucus blocks small ducts
Lung colonisation and infection (haemophilus influenzae, staph aureus, pseudomonas aeruginosa, atypical mycobacteria, Candida albicans)

Question 3

Describe the role of pseudomonas aeruginosa as an important organism in CF

Answer 3

Gram -ve coccobacillus aerobe
Mucoid
CF patient –> slime (biofilm), extracellular mucopolysaccharide