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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. nonliving physical chemical. Inflammation - causes. living prions (?) viral bacterial
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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
nonliving physical chemical Inflammation - causes • 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 > 20/min. • tachycardia > 90/min. • temperature > 39 st. C. (ev. < 36st.C) • leucocytosis > 15 000/1l(ev. < 4000/1l)
Endotoxin, toxins G+ Macrophages Cytokins NO PAF (Platelets Activating Factor) TNF, IL–1 TNF, IL–1, IL–6 NO synthesis vasodilation coagulation Sepsis – PathogeneticFactors
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
General Natural defenses Inflammation Immune status Successful transmission Site of attack Number of microorg. Pathogenicity Host & Microorganism Encounter
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 Host
Successful transmission Site of attack Number of microorg. Pathogenicity invasiveness toxin production multiplication resistence to host defence mechanisms ability to cause necrosis enzyme release Microorganism
INFECTIONversusDISEASE • 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
non infectious physical chemical Inflammation - causes • 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……)