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
 living
prions (?)
 nonliving viral
physical bacterial
chemical 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 > 15 000/1l (ev. < 4000/1l)
Sepsis – Pathogenetic Factors
 Endotoxin, toxins G+ TNF, IL–1
 Macrophages TNF, IL–1, IL–6
 Cytokins NO synthesis
 NO vasodilation
 PAF (Platelets
Activating Factor) 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 > 15 000/1l (ev. < 4000/1l)

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 & Microorganism
Encounter

 General  Successful
 Natural transmission
defenses  Site of attack
 Inflammation  Number of microorg.
 Immune status  Pathogenicity
 Host  Inflammation
– leucocytes
– macrophages
 General -phagocytosis
– age, race, nutrition, other
diseases (diabetes)  Immune status
 Natural defenses – immunity (or lack of
it)
– skin, mucose integrity
active, passive
– mucus, cilliary action, immunisation, contact
unobstructed flow
– lymphocytes
– protective secretion
(lysosym in tears, gastric – immunoglobulins
acid, IgA – 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
 infectious
prions
 non viral
infectious bacterial
physical mycotic
chemical 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……)