WEEK 5 infl--4.pptx

8/10/2019 WEEK 5 infl--4.pptx

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TYPES OF ACUTE INFLAMMATION

I. Suppurative inflammation.

II. Non suppurative inflammation:

Includes:

(1) Catarrhal inflammation.

(2) Membranous inflammation. (3) Sero-fibrinous inflammation.

(4) Fibrinous inflammation.

(5) Serous inflammation. (6) Haemorrhagic inflammation.

(7) Necrotizing inflammation.

(8) Allergic inflammation.


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I. SUPPURATIVE INFLAMMATION

(Pyogenic or Septic)

Definition:Severe acute inflammation characterizedby pus formation.

Causes: Pyogenic pus forming) microorganisms

as staphylococcus aureus, streptococcus haemolyticus,pneumococcus.

Types of Suppurative I nf lammation:

(1) Localized: (a) Abscess, (b) Furuncle, (c)Carbuncle.

(2) Diffuse: e.g. Cellulitis, suppurative appendicitis,suppurative peritonitis ... etc.


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A-LOCAL SUPPURATIVE INFLAMMATION

1- Abscess Definition: A localized suppurative

inflammation resulting in the formationof an irregular cavity containing pus.

Cause: Commonly Staphylococcusaureus.

Site:Commonly the abscess occurs in thesubcutaneous tissue, but occur in anyorganas the lung, brain, liver ... etc.

Composition of Pus:

o (1) Bacteria living and dead and theirtoxins.

o (2) Liquefied necrotictissue.

o (3) Inflammatory cellularexudate in theform of polymorph- leucocytes, many

pus cells, macrophages and red cells.o 4 Inflammator fluidexudate.


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Pathogenesis of Abscess Formation

1.Pyogenic microorganisms cause tissue necrosis by itstoxins and exert strong chemotaxis on polymorph-

nuclear leucocytes.2.Many leucocytes (neutrophil) are killed during theirstruggle bacteria and are called pus cells.

3.The dead leucocytes release proteolytic enzymes which

cause rapid liquefaction of the necrotic tissue.The resulting fluid material mix with the fluid andcellularexudate forming the pus (dilution of toxins).

M/E: (zone formation)Early:- central necrotic tissue.

peripheral area of acute inflammation surround it.Late : - central necrotic tissue. - pus cavity surround it.area of acute inflammation [ pyogenic membrane]surround it with excess neutrophils.

N/E : cardinal signs of acute inflammation


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opening

A cavity containing puspyogenic membrane

subcutaneous fat


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ACUTE INFLAMMATIONSUPPURATIVE / PURULENT - ABSCESS

Fate of abscess : pus in body

must be evacuated.

Pus can be evacuated either :

1. Surgical method : healing.

2. Spontaneously

PUS

=

PURULENT

ABSCESS

=

POCKET OF PUS


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Complications of Abscess Formation(1) Lymphatic spread of infection causes

lymphangitis(inflammation of lymph vessels) and

lymphadenitis (inflammation of L.Ns.

(2) Blood spread of bacteria and its toxins causes

a:bacteraemia ,

b: septicemia (circulation , multiplication of largenumber of pathogenic bacteria & their toxins inblood without localization).

c: toxaemia (toxinsin blood).

(3) Inadequate drainage and treatment changes theabscess to a chronic one. A chronic abscess has athick fibrous wall.

(4) Complications of healing in the form of chroniculcer sinusand fistula

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UlcerBasic description: Loss of the mucosa and

deeper tissues including basement

membranethe correct term is ulcer. If only the mucosa is lost with intact

basement membrane, the correct term is

an erosion.

Microscopic morphology of an ulcer:

The layers, from superficial to deep, are

fibrin, neutrophils, granulation tissue, and

fibrosis.Location: Most commonly seen in the

gastrointestinal tract and other tissues.

Complications of an ulcer:


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SINUSblind ended tract open on surface


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FistulaBasic description: A fistula is an

abnormal tunnel connecting two bodycavities (hallow organ) (such as the

rectum and the vagina) or a body

cavity to the skin(like the rectum to the

outside of the body).

Example:

Entero-cutaneous fistula

Biliary fistula: connecting the bileducts to the skin surface, often caused

by gallbladder surgery

Rectovaginal fistula: between the

rectum and vagina


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2- Furuncle (Boil)

Small abscess related to

a hair follicle orsebaceous gland causedby staphylococcus

aureus.Common sites are face

and back of the neckinmales and axilla infemales.

Multiple furuncles arecalled furunculosis.


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3- CarbuncleDefinition: A type of

localized suppuration

forming multiple communi-cating suppurative foci in theskin and subcutaneous fatdischarging pus throughseveral openings.

Cause: Staphylococcusaureus. Diabetes mellitus is acommon predisposing factor.

Sites: Areas where the skinand subcutaneous tissue arethick and tough as the backof the neck and buttocks.

B DIFFUSE SUPPURATIVE INFLAMMATION


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B-DIFFUSE SUPPURATIVE INFLAMMATIONCellulitis (Phlegmonous Inflammation)

Definition: Acute diffusesuppurative inflammation.

Cause: Streptococcushaemolyticus.

The organism produces twoenzymes:

(1)Fibrinolysin(streptokinase): Dissolvesfibrin.

(2) Hyaluronidase (spreading

factor): Dissolves hyaluronicacid of ground substancehelping spread of bacteria andits toxins.

Sites: Loose connective tissueas subcutaneous tissue
http://images.google.com/imgres?imgurl=http://www.aad.org/education/students/_img/DCImpetigoCellulitis3.jpg&imgrefurl=http://www.aad.org/education/students/impetigo_Cellfig3.htm&usg=__OSbRZqUejsfEBjTyE71JLK0JzFY=&h=250&w=375&sz=23&hl=ar&start=59&zoom=1&itbs=1&tbnid=CsbiJGTr0TNcOM:&tbnh=81&tbnw=122&prev=/images?q=Cellulitis&start=42&hl=ar&safe=active&sa=N&ndsp=21&tbs=isch:1


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Pathology of CellulitisThe basic pathological changes

are similar to those of abscesswith the following differences:(1) Failure of localization because

of absence of fibrin (No pyogenicmembrane).

(2) The necrosis is extensive

(3) Pus formation is slow. Pus isthin in consistency and maycontain many red cells i.e.

sanguineous.Complications:(1) Acute lymphangitis and

lymphadenitis.

(2) Septicemia.


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(3) Neurofibromatosis

A hereditary familialdisease transmitted as adominant trait. The diseaseis characterized by:

(a) Multiple neurofibromaswhich appear as small firm

nodules in the skin alongthe course of thecutaneous nerves.

(b) Cafe au lait skinpigmentation.

(c) Pigmented irishamartomas called Lischnodules.

Malignant tumours:Malignant Schwannoma(neurofibrosarcoma).

Multiple neurofibromas

Cafe au lait skin

Malignant NeurofibromaPlexiform Neurofibroma

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WEEK 5 infl--4.pptx