SEPSIS MENINGOCOCCOUS DISEASE SEPSIS Sepsis is general severe
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SEPSIS MENINGOCOCCOUS DISEASE
SEPSIS § Sepsis is general severe infectious disease, caused by permanent or recurrent microorganism admission into blood from primary focus of infection. Sepsis is a polyetiologic, non contagious disease characterized by generalized infection, acyclic clinical course, and special significance of changed reactivity.
SEPSIS Difference from other infectious diseases: 1 polyetiologic causes: pyogenic bacteria, fungi; 2 non contagious, 3 non reproduce in experiment; 4 clinical course is stereotype, it is no depends on etiologic agent;
SEPSIS 5 the most common sign of generalized infection is metastatic foci at a distance from primary focus; 6 cyclic course is absent; 7 incubation period is absent; 8 immunity is absent; 9 hyperergic reaction is predominance
SEPSIS ETYOLOGY: § BACTERII § FUNGI § And may be viruses
SEPSIS Clinical morphological forms: § 1 septicopyemia; § 2 septicemia; § 3 septic shock
SEPSIS § Gram positive microorganisms are infective agent for septicopyemia, § Gram negative microorganisms are infective agent for septicemia or septic shock
SEPSIS Classification according to entry of infection: § 1 therapeutic sepsis; § 2 surgical sepsis; § 3 gynecologic sepsis; § 4 umbilical sepsis;
SEPSIS § 5 tonsilogenic sepsis; § 6 odontogenic sepsis; § 7 ottogenic sepsis; § 8 urogenic sepsis; § 9 cryptogenic sepsis (without entry of infection).
SEPSIS § umbilical sepsis liver navel Secondary foci liver
Pathogenesis of SEPSIS § Infective agent § Entry of infection § Initial focus state § Organism reactivity § Lymphogenic spread is lymphangitis and lymphadenitis § Hematogenic spread is phlebitis and thrombophlebitis with bacterial thromboembolism
SEPSIS Septicopyemia is the form of sepsis characterized by purulent inflammation § (abscesses, phlegmonon, interstitial purulent inflammation) § In various organs and tissues due to § Hematogenic spread of microbe emboli from primary septic focus. § Septicopyemia is sepsis with purulent metastases.
SEPTICOPYEMIA § Purulent metastases as abscess Abscess of the lung Abscess of the heart
SEPTICOPYEMIA § Abscess of the kidney
SEPTICEMIA § Septicemia is very shot way to septicopyemia, but patient does not live so long. § Septicemia is systemic inflammative reaction with general lesion of circulatory bed.
SEPTICEMIA § Septicemia is disability of organism capability to produce leukocyte infiltration. § Septicemia is sepsis without purulent metastases.
Purulent absorption fever § It is termed by I. V. Davidovsky. § Nowadays is associated with chroniosepsis § It manifestoes local purulent and necrotic processes. § It appears intoxication with cachexia and amyloidosis as complications.
Intoxication § DIC-syndrome, § Hemorrhagic syndrome, § Dystrophy, § Necrosis, § Hyperplasia of the spleen, lymph nodes and red marrow § Metaplasia fatty bone marrow into red marrow
Infective ENDOCARDITES Infective (Bacterial) endocarditis is a group of inflammatory diseases with microbial invasion of heart valves, Mural endothelium, aortic endothelium, large artery endothelium and intra cardiac artificial materials. Infective endocarditis may have clinical course like sepsis or they may have sepsis as complication.
Infective endocarditis § Entry of infection is cardiac valves § 70% are with previous rheumatic valve disease. § 30% lesion of normal valves is named Tchernogubov’s disease § Allergic reaction directs infective endocarditis course.
Infective endocarditis § Acute endocarditis - 2 weeks § Subacute one – 3 months § Chronic endocarditis – years. § Etiology: Streptococci, Staphylococci Enterococci, Gramm-negative and Fungi.
Infective endocarditis § § Normal Polypous ulcerous endocarditis Result is in Aortic valve disease
INFECTIVE ENDOCARDITIS Acute form of polypous-ulcerous endocarditis includes: § Friable, bulky and potentially destructive vegetations containing fibrin, inflammatory cells, and microorganisms. § The aortic and mitral valves are the most common sites for infections.
Infective endocarditis MICROSAMPLE Microbial colonies
INFECTIVE ENDOCARDITIS Subacute form includes: § Vegetations with granulation tissue and chronic inflammatory infiltrate. Fibrosis and calcification.
INFECTIVE ENDOCARDITIS Complications are emboli as fragmented vegetation. § Emboli lodges are leading to development of septic infarcts or mycotic aneurisms of the artery and aorta § The cure is antibiotic therapy and valve replacement.
MENINGOCOCCOSIS Meningococcosis is an infectious disease included three forms: 1 acute nasopharyngitis 2 purulent leptomeningitis 3 meningococcemia
MENINGOCOCCOSIS § Etiology: Neisseria meningitidis § Pathogenesis: Meningococcosis is a respiratory infection and Neisseria can overcome haemato-encephalic barrier. The entries of infection are mucous membrane of the nose and the throat.
Leptomeningitis § Purulent leptomeningitis is an inflammation of brain and spinal cord pia mater. § There are four clinical courses: fulminant, acute, subacute, chronic
Leptomeningitis § Acute purulent leptomeningitis. § The yellow-tan clouding of the meninges seen here is due to an exudate from acute meningitis.
Leptomeningitis § a neutrophilic exudate is seen involving the meninges § at the left, with prominent dilated vessels. There is edema and focal inflammation
Neisseria meningitides. § a gram stain reveals gram negative diplococci within a neutrophil, typical for Neisseria meningitidis.
Leptomeningitis Complications are as follow § Purulent meningoencephalitis § Thrombophlebitis, § Hemorrhagic infarction of the brain § Fibrous adhesions § Hydrocephalus
Hydrocephalus § Note the marked dilation of the cerebral ventricles. This is hydrocephalus. Hydrocephalus can be due to lack of absorption of CSF or due to an obstruction to flow of CSF.
Hydrocephalus § This is a computed tomographic (CT) scan demonstrating enlarged lateral ventricles in a patient with hydrocephalus. This condition has been treated by placing two shunts (the thin white objects).
MENINGOCOCCEMIA § Meningococcemia develops in a clinical course as meningococcal sepsis and manifestoes in DIC-syndrome, hemorrhagic diathesis, necrosis of the organs.
MENINGOCOCCEMIA § Hemorrhagic rash on the skin
MENINGOCOCCEMIA Fulminant form reveals hemorrhage within bilateral adrenal with acute adrenal insufficiency described as Waterhouse- Frederickson syndrome, which may be the cause of death
MENINGOCOCCE MIA § Waterhouse- Frederickson syndrome
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