Bacterial Infection

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It is invasion of tissues by living micro-organisms
Microorganisms include:
1-Bacteria (Most of them are Harmless and few
are Pathogenic)
2-Viruses
3-Fungi
4-Parasites

Infestation = Parasitic invasion

ROUTES OF ENTRY OF MICRO-ORGANISMS

• Skin or mucous membrane:

– Close contact: e.g. Venereal diseases as syphilis and
gonorrhea
– Inoculation: e.g. Hepatitis B &C, AIDS
– Wound and abrasions: e.g. Skin infection ,Tetanus and
Rabies
• Ingestion: e.g. Hepatitis A, typhoid, shigella group
• Inhalation: e.g. Influenza, diphtheria and
tuberculosis
 Bacterial infection
Pathogenicity: It is the ability of bacteria to produce
disease (spread, multiply and cause tissue damage)
- Virulence and dose of organism
- Resistance of the body: It depends on
1-Mechanical barrier: as Keratin of the skin
2-Glandular barriers: as acidity by sweat glands, IgA
secretion by mucous membranes and in milk
3-Secretory currents: as urine, saliva wash bacteria and
decrease its concentration
4-Immune system, mediated by antibodies or by
lymphocytes
Body resistance is lowered by
1-Severe fatigue
2-Exposure to cold
3-Chronic debilitating disease .eg: diabetes mellitus
4-patients receiving immunosuppresive drugs

Pathological effects of bacteria are produced by:

1-Production of toxins
2-Immune reaction
 EFFECTS OF BACTERIAL INFECTION
1- Inflammation:
• Acute: e.g. Diphtheria
• Chronic: e.g. T.B.
2-Production of toxins: causing toxemia
3- Spread of infection
• Local ----------To surrounding tissues leading to cellulitis
and abscess (bacteria move or inside phagocytes)
• Lymphatic -- To lymph nodes (Lymphadenitis)
• Blood Causing: 1- Bacteremia
2- Septicemia
3- Pyemia
• Natural Passages As ureter
TOXEMIA: Presence of bacterial toxins in the blood
Exotoxins Endotoxins
Secreted by living bacteria Released after death of bacteria
Source present in the wall

Types of bacteria Usually G+ve G-Ve

Protein lipopolysaccharides
Structure
Potent Weak cytotoxicity
Potency
By specific antibody Not neutalized by Ab
Neutralization
-They have enzymatic effects as -VD of arterioles leading to shock
Mode of action proteases,phosphatases,lipases -Activation of Hagman factor
-They have specific actions on tissues and -Aggregation of platelets
organs eg flaccid paralysis in botulism, -Activation of complement
and spasticity in tetanus due to inhibiting (increase coagulability of the blood)
release of glycine from spinal cord.

Examples Diphtheria, Tetanus Meningococci

Clostridia botulism gonococci
Cholera Vibrio Typhoid bacilli
Shigella group Pneumococci
Manifestations and pathological lesions of toxemia:
Types of toxemia Acute toxemia Chronic toxemia

Examples Diphtheria, typhoid, cholera, Tuberculosis, Syphilis

tetanus, botulism..
Manifestation and -Fever, headache, rigors, pain -Low grade fever
effects allover the body -Anaemia: normocytic
-Fatty change & necrosis e.g. Liver normochromic due to bone
- Toxic myocarditis leads to AHF marrow depression
- Necrosis of adrenal cortex leads -Amyloidosis
Acute adrenal insufficiency -loss of weight
- Tubular necrosis of kidney leads
to Acute renal failure
- Endotoxic septic shock & DIC
- Respiratory muscle paralysis and
asphyxia with tetanus exotoxin
-Specific actions of toxins;
eg: tetanus bacilli toxins increases
neuromuscular activity leading to
spasm of respiratory muscles
 Bacteraemia
Definition:
• It is the presence of small number of low virulent
bacteria in the blood from time to time
Causes:
1- May be derived from septic focus of infection
e.g. Dental sepsis, chronic tonsillitis, chronic
sinusitis, chronic cholecystitis, chronic otitis media
2-After minor surgical procedures as tonsillectomy
and tooth extraction
3-After brushing of teeth
4-Urinary catheterization
Effects of Bacteremia
• Small dose of bacteria is destroyed by reticulo-
endothelial system that are macrophages in the
spleen, lymph nodes, liver and bone marrow
• Large dose of the bacteria may settle in different
organs causing severe inflammation e.g.
– BONE: Acute hematogenous osteomyelitis
– HEART: Infective Endocarditis (SBE)
– KIDNEY: Pyelonephrtitis
– MENINGES: Acute suppurative meningitis
 Septicaemia
Definition: It is circulation and multiplication of
bacteria in blood with production of toxins
Causes of Septicemia
A-Primary infection by highly virulent organisms
(Primary Septicemia) e.g. Meningococci, streptococci
B-As a complication of suppurative diseases as:
1-Puerperal sepsis, 2-Suppurative osteomyelitis,
3-Otitis media, 4-Infected wounds
C-In patients receiving immunosuppressive drugs
Pathological effects of Septicemia
(Post Mortem Effects)
1-Petechial hemorrhages allover the body due to toxic
capillaritis
2-No post mortem clotting of the blood.
3-Massive bilateral adrenal Hemorrhages
4-Acute bacterial endocarditis with formation of septic
vegetations
5-Serofibrinous inflammation of the serous membranes
eg Pleurisy, pericarditis, peritonitis
6-Septic shock
7-Acute Splenic Swelling (Septicaemic Spleen):
GROSSLY:
• The spleen is:- Enlarged, soft & congested
• Dark red pulp easily washed by water

MICROSCOPICALLY:
• Congestion of the sinuses and neutrophilic
infiltration
• Atrophy of white pulp
 PYEMIA
Definition:
• It is the formation of multiple small abscesses
in different sites and organs due to impaction
of septic emboli in small blood vessels. Known
as pyemic abscesses
Characters of Pyemic Abscess
1-Multiple
2-Small and rounded
3-Nearly the same size
4-Peripheral in position
5-Surrounded by zone of congestion

Pathogenesis of Pyemia
• Infection beside vein lead to septic Thrombophlebitis
then fragmentation and septic emboli formation that
settle in different organs.
 Types of Pyemia
SYSTEMIC PYEMIA PORTAL PYEMIA
-The septic emboli are carried by the The septic emboli are carried by portal
systemic veins to heart then pulmonary circulation to settle in the liver
arterioles where they settle in the lung
Causes:
Causes: -Suppurative cholecystitis
- Acute osteomyelitis -Suppurative pancreatitis
- Puerperal sepsis -Acute suppurative appendicitis
- Suppurative otitis media -Infected and thrombosed piles
- Septic emboli are carried by systemic
arteries from the lung and heart to other
organs as liver, spleen, kidney and brain
-Acute bacterial endocarditis
-Suppuration in the lung
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 Any Questions?

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