Inflammation 3: Acute suppurative Inflammation

Question 1

Define acute suppurative inflammation

Answer 1

acute inflammation formed by virulent bacteria, forming pus as a result

Question 2

define pus

Answer 2

Liquefied material mixed with Pus cells, exudate, neutrophils & necrotic fluid

Question 3

describe pathogenesis of pus

Answer 3

1. Virulent bacteria causes necrosis of tissue
2. as a result, it attracts neutrophils
3. it then kills neutrophils by leukocidins, causing leukocytes (neutrophils) to die and release their proteolytic enzymes
4. proteolytic enzymes cause digestion & liquefaction of necrotic tissue

Question 4

Pus cells are ____

Answer 4

dead neutrophils

Question 5

virulent bacteria kills neutrophils by ____

Answer 5

leukocidins

Question 6

description of pus

Answer 6

• tubrid creamy
• Doesn’t coagulate on standing
• yellow when caused by staphelococus aureus
• sanguineous when caused by streptococus
• green when caused by pyocyaneous

Question 7

types of Acute suppurative inflammation

Answer 7

• Localized suppurative
• Diffuse suppurative

Question 8

explain why pus doesn’t coagulate on standing

Answer 8

due to release of proteolytic/lysosomal enzymes

Question 9

bacteria causing Localized Suppurative acute inflammation

Answer 9

Staphylococcus Aureus

Question 10

bacteria causing Diffuse Suppurative acute inflammation

Answer 10

Streptococcus hemolyticus

Question 11

Enzyme specific to staphylococcus Aureus, and its function

Answer 11

Coagulase enzyme;
localization of bacteria by formation of Fibrin

Question 12

Enzyme specific to Streptococcus hemolyeticus & function

Answer 12

• Spreading factor= Hyaluronidase enzyme
• Virulence factors= streptokinase & Fibrolysin

their function is spreading of the bacteria

Question 13

Enumerate types of Localized Suppurative Acute inflammations

Answer 13

1. Furuncle (boil): hair follicle (folliculitis)
2. Carbuncle: multiple communicating SC absesses with multiple sinuses at the surface
3. Abscess

Question 14

most common site for carbuncle

Answer 14

in the back of the neck

Question 15

Carbuncle is more in pateints with ____

Answer 15

Diabetes

Question 16

Enumerate & describe complications arriving with abscess

Answer 16

1. Spread:
   direct
   Blood (septicemia, toxemia, pyemia)
   Lymphatics (lymphangitis, Lymphadenitis)
2. Ulcer: local defect with surface
3. Sinus: blind ended tract connecting deep abscess to surface
4. Fistula: Double ended tract connecting 2 surfaces or hollow organs
5. Keloid
6. Rupture
7. Hemorrhage
8. Chronicity of the abscess
9. Putrefaction
10. Compression

Question 17

Cause of Abscess

Answer 17

Pyogenic bacteria= Staphylococcus aureus bacteria

as it is a Localized suppurative acute inflammation

Question 18

enumerate routes of abscess formation

Answer 18

• bacteria is seeded into tissue (such as in surgery)
• Secondary infection of necrotic tissue

Question 19

Describe the morphology of abscess

Answer 19

3 zones:
* Central: Necrosis (which gradully decreases peripherally)
* Mid Zone: Liquifaciton zone (pus)
* Peripheral zone: pyogenic membrane

Question 20

Pyogenic membrane/ Abscess is area is rimmed by:

Answer 20

• Neutrophils (preserved)
• macrophages
• Dilated capillaries
• fibrin
• Fibroblasts

Question 21

fate of abscess

Answer 21

• Small: absorbed then healed
• Large: if not surgically removed, it ruptures (evacuation) and then heals by scar tissue

Question 22

describe pus of diffuse suppurative acute inflammation

Answer 22

thin & sanguineous (colour of blood) (due to hemolysis of RBCs)

Question 23

Enumerate types of diffuse suppurative acute inflammation

Answer 23

1. Cellulitis
2. acute diffuse suppurative appendicitis
3. septic peritonitis

Question 24

cellulitis is more common in patients with ____

Answer 24

Diabetes

Question 25

common site of cellulitis

Answer 25

• Loose tissue= subcutaneous
• Loose areolar tissue= Scrotum or Orbit