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Infection
Dr. Tarek Atia
Pathogenesis
Immunity
Infection
1- Toxaemias
- Toxaemia means circulation of bacterial toxins in the
blood with production of clinical manifestations.
tachycardia.
- Affect the kidney: tubular necrosis, acute renal failure.
- Affect the heart: toxic myocarditis.
- Affect the liver: fatty liver
- Toxic shock
- Peripheral neuritis
2- Bacteraemia
- It means circulation of bacteria, from a septic focus
(sinusitis, otitis media, tonsillitis, ..), in the blood with
production of clinical manifestations.
3- Septicemia
It means multiplication of bacteria and their
4- Pyaemia
- It means production of multiple small abscesses in
different organs due to circulation and impaction
of septic emboli started from a septic focus.
- According to the site of the original septic focus;
pyaemia can be classified into: Systemic or Portal
Tuberculosis
Tuberculosis (TB)
Communicable disease
It is a chronic granulomatous disease
Causative organism: Mycobacterium tuberculosis;
tubercle bacilli of two types (human and bovine),
Typically results in caseating (necrosis) granulomas
Route of infection
Respiratory tract: Inhalation of infected
droplets from patient with open TB.
Pathogenesis
Macrophages are the primary cells infected by M.
tuberculosis.
Early in infection bacilli replicate & are
essentially unchecked
later in infection T-helper response stimulates
macrophages to contain the proliferation of the
bacteria.
Pathogenesis
Types of Tb infection
Primary TB
- Nature: Infection for the 1st time
- Age:
Secondary TB
- Re-infection (2nd time)
Children
- Adult
- Well developed
- Exudative
- Anywhere
Primary TB
In Non Immunized individuals (Children)
Primary Tuberculosis:
Primary Progressive TB
Miliary TB and TB Meningitis.
Sites of 1ry TB
- 1ry cervical complex: TB tonsillitis, TB lymphadenitis,
TB lymphangitis.
lymphadenitis, TB lymphangitis .
Ghon`s Focus
Small rounded about 1cm
focus, present anywhere in
the
lung,
commonly
Secondary Tuberculosis:
Post Primary in immunized individuals.
Reactivation or Reinfection
Caseation, cavity - soft granuloma
Pulmonary or extra-pulmonary
Local or systemic spread / Miliary
Vein via left ventricle to whole body
Artery miliary spread within the lung
Cavitary Tuberculosis
When
necrotic
tissue
is
coughed up cavity.
Cavitation is typical for large
granulomas.
Cavitation is more common
in the secondary reactivation
tuberculosis - upper lobes.
Fate of Tuberculosis
1- When the body resistant is good: healing occurs by
fibrosis, followed by calcification and ossification.
2- When the body resistant is low: spreading of the
infection :-Blood
- Direct along the tissue space
- Along the natural passages
- Along the serous cavities as pleura
- Lymphatic to the regional lymph nodes
Morphology of granuloma
1. Collection of chronic inflammatory cells.
2. Central Caseous necrosis.
3. Active macrophages - epithelioid cells.
Epitheloid cells in
granuloma
Caseation necrosis
Typical Cavitating
Granuloma
TB Brain
TB intestine