INFECTION
Prof Dina Allam
1- Define infection.
2- Explain the mechanism of
infection.
ILOS: 3- Identify complication of bacterial
infection.
4- Recognize differences between
bacteremia, septicemia and pyemia.
Invasion and proliferation of micro-organisms in
the tissues of the body.
COMMENSALS
These are micro-organisms that constitute the normal flora of a
healthy body.
They do not normally cause disease and they are often
advantageous to the host by the production of nutrients,such
as vitamin B12, and by the exclusion of harmful bacteria.
For example, the normal commensal flora of the skin prevents
colonization by pathogenic bacteria.
Pathogens:
Pathogens are microorganisms that are normally absent from
the body but which have mechanisms to invade and cause
infection.
•Living with the host
commensals
•Not cause harm
•Absent from the host
pathogens
•Cause harm
PATHOGENESIS OF INFECTION
HOST VIRULENCE
DEFENSE
VIRULENCE FACTORS
Adhere to host cells,
Invade cells and tissues
Toxins (exotoxins and
endotoxins).
MODE OF
INFECTION
MECHANISMS OF DEFENSE
The majority of infectious agents encountered by an individual are
prevented from entering the body by variety barriers.
Infectious
agents
• Local spread
can • Lymphatic spread
spread to •
•
Haematogenous spread
Dissemination in the
distant tissue fluid
• Neural spread.
tissue
sites by:
What is complication of bacterial infection?
Bacterial
Toxins
Weak Virulent
Bacterial Bacteria + Thrombophlebitis+
Bacteraemia toxins in Toxins in septic emboli
blood blood
Toxaemia Septicemia Pyemia
• Transient presence of small number of bacteria
without significant toxic manifestation.
Bacteraemia
• Bacteria in the blood either be destroyed by
immunesystem or be localized in tissue producing
infection.
After tooth
• Streptococcus viridans (commensals)
extraction:
Examples:
Septic focus
• Staph. aureus
(Abcess)
TOXAEMIA:
Circulation of bacterial toxins in the blood causing pathological and clinical manifestation.
Toxins Onset
• Exotoxic: • Acute:
• exotoxins are proteins • Large amount of
secreted by bacteria toxins in short
during life. duration (diphtheria,
• Endotoxic: tetani)
• integral parts of • Chronic:
bacterial cell walls,
released only when • Small amount of
the bacterium dies. toxins in log duration
(T.B)
1 Toxic symptoms (due to cytokine
release): fever, weakness, pallor, headache
and rigors
Clinical picture:
2 Degeneration: in parenchymatous organs
such as cloudy swelling, hydropic
degeneration and fatty changes
3 Necrosis: acute heart failure due to toxic
myocarditis and acute adrenal insufficiency
due to toxic necrosis of adrenal cortex
4 Bone marrow depression causing
anaemia and leukopenia
SEPTICAEMIA:
Highly fatal condition characterized by
circulation of large number of virulent
bacteria and their toxins in the blood
stream.
Source of infection:
• Severe bacteria such as:
• staph aureus, strept haemolyticus,
meningococci, pneumococci
• Ordinary bacteria in low immunity
Pathological features (acute fatal manifestation):
Toxins:
• CP of toxaemia
Virulent bacteria
• Acute splenic swelling: Large, with soft friable cut
section.
• Septic: Petechial hge, jaundice, leukoplastic
reaction. (BM depression, hemolysis RBCs, low plat,
High WBCs)
• Suppurative inflammation, serous sacs
Bacteraemia Septicaemia
Circulation of small Circulation of large number
Definition number of bacteria or of virulent types of
weak bacteria bacteria
Toxins No toxins in blood Exotoxins or endotoxins
Immunity Immunocompetent Immune compromised
of
patients
C\P Asympyomatic Symptomatic; toxic
manifestation
Fate
Destroyed by immune
system or localization Fatal
(osteomyleitis or Subacute
bacterial endocarditis
PYAEMIA:
Definition:
Circulation and impaction of
septic emboli in the blood stream
followed by their arrest in different
organs causing multiple small
abscesses.
Infection
Septic
Septic
Pyemia
Clinical picture:
toxic manifestation like toxaemia
pyaemic abscesses in lung, liver or other organs
usually are multiple, peripheral with central yellow
area surrounded by hyperemic red area
Multiple, small, peripheral, round, no fibrois