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HC19: Pathology of infectious diseases
Infectious diseases
In 80% of cases, the pathologist finds infectious disease patterns while trying to exclude malignancy. In 20% of cases, they get a biopsy intended to prove infectious origin. Pathologists try to think in patterns.
Spectrum of inflammatory responses
There is a spectrum of inflammatory responses to infection, which consists of 5 forms of inflammation:
- Suppurative/(purulent) acute inflammation → gram-positive or gram-negative bacteria
- Most common
- Acute inflammation
- Many neutrophils are present
- Pus is visible
- Mononuclear/granulomatous inflammation → mycobacteria, spirochetes, parasites, viruses
- Chronic inflammation
- Cytopathic-cytoproliferative inflammation → HSV, adenovirus, herpes virus, HPV
- Infected cells start proliferating under influence of viruses → necrotic responses
- Can lead to death very quickly
- Infected cells start proliferating under influence of viruses → necrotic responses
- Chronic inflammation and scarring → hepatitis B
- Mainly lymphocytes and specific antibody-producing cells are present
- Tissue necrosis → clostridium, hepatitis B
- No reaction → immune deficient host
Lung infections
If, on a CT scan, there are spots visible in the lung, its either malignancy or an infection. If there is a mononuclear or granulomatous infection in the lung, it most definitely is a case of TBC. Caseous necrosis are cavities in the lung made of dead cells, which is very common for TBC.
Testis
The testis is very difficult to biopsy, but the probability of malignancy in the testis is very high. It can be confused with TBC, which can also occur in the testis → it enters the blood stream and lymph nodes via the lungs. However, this is super rare.
Caveating/cystic lesion in the lung
An infection can lead to a caveating or cystic lesion in the lung. This is done by the echinococcus parasite, which can make cystic walls around itself and create holes in the lungs → echinococcus cysts. If the cyst is ruptured, new larvae can be made everywhere.
Graft versus host disease
Graft versus host disease can happen after a bone marrow transplant. It is a form of immunodeficiency. It can cause cytopathic or cyto-proliferative patterns → virus infections, for instance HPV or CMV associated pneumonitis. Usually, this virus can be destroyed by a well-functioning immune system. However, this can be dangerous in case of bone marrow transplantation → it can cause Graft versus host disease.
POX-virus
POX-virus can cause molluscum contagiosum ("waterwratten"). This is very contagious, but usually goes away by itself.
Herpes simplex
In case of herpes simplex ("koortslip") there is an excessive amount of cells, paired with blisters. It is cyto-proliferative.
Syphilis
Ulcerating skin lesions can be caused by plasma cell infiltrations → mononuclear infiltrations. This disease is called syphilis, which is caused by spirochetes.
Hyphen invading vessel walls
Aspergillus fumigatus is a fungus that not only can spread through the body via blood vessels, but also can destroy the vessel wall → hyphen invading vessel walls. This way, the fungus can spread through the entire human body. It is very rare and only happens when one is immunodeficient.
Mechanisms of Disease 1 2020/2021 UL
- Mechanisms of Disease 1 HC1: Introduction to G2MD1
- Mechanisms of Disease 1 HC2: Introduction to the immune system
- Mechanisms of Disease 1 HC3: Innate and adaptive immune responses & key cytokines
- Mechanisms of Disease 1 HC4: Pathology of normal immune response
- Mechanisms of Disease 1 HC5: B- and T-cell generation and diversity
- Mechanisms of Disease 1 HC6: Mechanisms of adaptive immunity
- Mechanisms of Disease 1 HC7: Effector mechanisms of antibodies
- Mechanisms of Disease 1 HC8: B-cell development and antibodies
- Mechanisms of Disease 1 HC9: Tissue injury and repair
- Mechanisms of Disease 1 HC10: Repair mechanism
- Mechanisms of Disease 1 HC11: Pathology of inflammatory reactions
- Mechanisms of Disease 1 HC12: Introduction to infectious diseases
- Mechanisms of Disease 1 HC13: Bacteria
- Mechanisms of Disease 1 HC14: Viruses
- Mechanisms of Disease 1 HC15: Fungi and parasites
- Mechanisms of Disease 1 HC16: Invaders
- Mechanisms of Disease 1 HC17: Host versus invader
- Mechanisms of Disease 1 HC18: Immune deficiencies and infection risk
- Mechanisms of Disease 1 HC19: Pathology of infectious diseases
- Mechanisms of Disease 1 HC20: Diagnostics of infectious diseases
- Mechanisms of Disease 1 HC21: Essential microorganisms
- Mechanisms of Disease 1 HC extra: Mycobacterial infections (tuberculosis)
- Mechanisms of Disease 1 HC22: Antimicrobial therapy
- Mechanisms of Disease 1 HC23: Principles of antibiotic pharmacotherapy
- Mechanisms of Disease 1 HC24: Introduction MOOC
- Mechanisms of Disease 1 HC25: Epidemiology
- Mechanisms of Disease 1 HC26: Prevention and control
- Mechanisms of Disease 1 HC extra: COVID-19
- Mechanisms of Disease 1 HC27: Mechanisms of hypersensitivity reactions
- Mechanisms of disease 1 HC28: Pathology of allergy
- Mechanisms of Disease 1 HC29: Asthma
- Mechanisms of Disease 1 HC30: Pathology of autoimmunity
- Mechanisms of Disease 1 HC31: HLA and autoimmunity
- Mechanisms of Disease 1 HC32: Vasculitis
- Mechanisms of Disease 1 HC33: Systemic Lupus Erythematosus
- Mechanisms of Disease 1 HC35: Infections and autoimmunity
- Mechanisms of Disease 1 HC36: Immune cells in rheumatoid arthritis
- Mechanisms of Disease 1 HC37+38: Pharmacology: immunosuppression
- Mechanisms of Disease 1 HC39: Pathology of transplantation
Mechanisms of Disease 1 2020/2021 UL
Deze bundel bevat aantekeningen van alle hoorcolleges van het blok Mechanisms of Disease 1 van de studie Geneeskunde aan de Universiteit Leiden, collegejaar 2020/2021.
This bundle contains notes of all lectures from the module Mechanisms of Disease 1, Medicine, Leiden
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