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General Pathology Basic Principles of Cellular and Organ Pathology Infection - I http://www1.lf1.cuni.cz/~jdusk/ Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague Inflammation - causes nonliving physical chemical living prions (?) viral bacterial mycotic parasitic AUTOIMMUNE Interaction of Organism and Microorganism – Terms Bacteriemia (transient) Sepsis/ Septicemia Pyemia Toxemia Viremia Bacteriemia transient presence of microbes in the bloodstream Sepsis / Septicemia (Severe Bacteremia) increasing numbers of microbes (& their toxins) in the bloodstream Sepsis/Septicemia Def. systemic response to infection manifestating as tachypnoe tachycardia temperature leucocytosis > 20/min. > 90/min. > 39 st. C. (ev. < 36st.C) > 15 000/1l (ev. < 4000/1l) Sepsis – Pathogenetic Factors Endotoxin, toxins G+ TNF, IL–1 Macrophages TNF, IL–1, IL–6 Cytokins NO PAF (Platelets Activating Factor) NO synthesis vasodilation coagulation Syndrome of Systemic Inflammatory Response Def. systemic response to an AGENT manifestating as tachypnoe > 20/min. tachycardia > 90/min. temperature > 39 st. C. (ev. < 36st.C) leucocytosis > 15 000/1l (ev. < 4000/1l) AGENT : pancreatitis, injury, burns….. Pyemia presence of infected thrombemboli bearing virulent microbes in the bloodstream Toxemia presence of microbial toxin (s) without the microbes themselves in the bloodstream Endotoxin lipopolysaccharide component of G- bacteria outer wall effects: fever, shock, DIC, RDS effects mediated by IL-1, TNF Exotoxins -1 often enzymes (leukocidins, hemolysins, hyaluronidases, coagulases, fibrinolysins) others…………. Exotoxins -2 diphteria toxin – inhibition of cellular proteosynthesis botulotoxin – block of the cholinergic transmission choleratoxin – increase in cAMP, losses of isoosmotic fluid via enterocytes Host General Microorganism Encounter & Successful transmission defenses Site of attack Inflammation Number of microorg. Immune status Pathogenicity Natural Host General – age, race, nutrition, other diseases (diabetes) Natural defenses – skin, mucose integrity – mucus, cilliary action, unobstructed flow – protective secretion (lysosym in tears, gastric acid, IgA Inflammation – leucocytes – macrophages phagocytosis Immune status – immunity (or lack of it) active, passive immunisation, contact – lymphocytes – immunoglobulins – complement Microorganism Successful transmission Site of attack Number of microorg. Pathogenicity invasiveness toxin production multiplication resistence to host defence mechanisms ability to cause necrosis enzyme release INFECTION versus DISEASE Pathogenicity (virulence) Incubation Period Carrier State Agent – Host Interaction cytocidal stabilised (steady– state) transformation – ONCOGENS Virus – Host Cell Interaction cytocidal stabilised (steady– state) transformation – ONCOGENS Inflammation - causes non infectious physical chemical infectious prions viral bacterial mycotic parasitic AUTOIMMUNE Infectious Agents of Humans prions viruses (DNA, RNA) bacteria (incl. chlamydia, mycoplasma, rickettsia – obligatory intracellular parasites) fungi (yeasts, molds) parasites (protozoa, helmints, ectoparasites- insects: lice, mites, ticks; spiders) Infectious Agents of Humans Bacteria simple cells – prokaryotes both DNA and RNA cocci, bacilli (AFB!), spirochetes…. Gram positive /negative extra- and/or intracellular aerobic/ anaerobic Infectious Agents of Humans Fungi complex cells – eukaryotes both DNA and RNA yeasts, molds (hyphae, pseudohyphae…) PAS, impregnation extra- or intracellular mostly opportune pathogens Infectious Agents of Humans Parasites -1 Protozoa complex cells – eukaryotes both DNA and RNA extra- or intracellular (Amebas, Trichomonas,Trypanosoma, Toxoplasma, Plasmodium, Pneumocystis…) Infectious Agents of Humans Parasites -2 Metazoa (helmints and flukes) multicellular both DNA and RNA flat and round worms extracellular (Taenia, Ascaris, Enterobius, Trichuris Echinococcus, Clonorchis, Schistosoma, Wuchereria…) Infectious Agents of Humans Parasites -3 Insecta, Arachnida multicellular both DNA and RNA extracellular (Sarcoptes scabiei, fleas, ticks, lice……)