Streptococcus pneumoniae infection pathophysiology: Difference between revisions
No edit summary |
|||
| Line 5: | Line 5: | ||
==Pathogenesis== | ==Pathogenesis== | ||
''S. pneumoniae'' is normally found in the [[nasopharynx]] of 5-10% of healthy adults, and 20-40% of healthy children. | ''S. pneumoniae'' is normally found in the [[nasopharynx]] of 5-10% of healthy adults, and 20-40% of healthy children. It can be found in higher amounts in certain environments, especially those where people are spending a great deal of time in close proximity to each other (day cares, army barracks). It attaches to nasopharyngeal cells through interaction of bacterial surface [[adhesin]]s. This normal colonization can become infectious if the organisms are carried into areas such as the [[Eustachian tube]] or [[nasal sinus]]es where it can cause [[otitis media]] and [[sinusitis]], respectively. Pneumonia occurs if the organisms are inhaled into the lungs and not cleared (again, viral infection, or [[Tobacco smoking|smoking]]-induced ciliary paralysis might be contributing factors). Once the organism makes its way to a site where it is not normally found, it activates the [[Complement system|complement]] protein group, stimulates [[cytokine]] production, and attracts [[white blood cell]]s (specifically [[neutrophil granulocyte|neutrophil]]s). The organism's [[polysaccharide]] capsule makes it resistant to [[phagocytosis]], and if there is no pre-existing anticapsular antibody, alveolar [[macrophage]]s cannot adequately kill the pneumococci. The organism spreads to the blood stream (where it can cause [[bacteremia]]) and is carried to the [[meninges]], joint spaces, [[bone]]s, and [[peritoneal cavity]], and may result in [[meningitis]], [[brain abscess]], [[septic arthritis]], or [[osteomyelitis]]. | ||
''S. pneumoniae'' has several virulence factors, including the polysaccharide capsule mentioned earlier, that help it evade a host's immune system. It has pneumococcal surface proteins that inhibit complement-mediated opsonization, and it secretes IgA1 protease that will destroy secretory IgA produced by the body. | ''S. pneumoniae'' has several virulence factors, including the polysaccharide capsule mentioned earlier, that help it evade a host's immune system. It has pneumococcal surface proteins that inhibit complement-mediated opsonization, and it secretes IgA1 protease that will destroy secretory IgA produced by the body. | ||
Revision as of 17:41, 2 February 2012
Template:Streptococcus pneumoniae Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathogenesis
S. pneumoniae is normally found in the nasopharynx of 5-10% of healthy adults, and 20-40% of healthy children. It can be found in higher amounts in certain environments, especially those where people are spending a great deal of time in close proximity to each other (day cares, army barracks). It attaches to nasopharyngeal cells through interaction of bacterial surface adhesins. This normal colonization can become infectious if the organisms are carried into areas such as the Eustachian tube or nasal sinuses where it can cause otitis media and sinusitis, respectively. Pneumonia occurs if the organisms are inhaled into the lungs and not cleared (again, viral infection, or smoking-induced ciliary paralysis might be contributing factors). Once the organism makes its way to a site where it is not normally found, it activates the complement protein group, stimulates cytokine production, and attracts white blood cells (specifically neutrophils). The organism's polysaccharide capsule makes it resistant to phagocytosis, and if there is no pre-existing anticapsular antibody, alveolar macrophages cannot adequately kill the pneumococci. The organism spreads to the blood stream (where it can cause bacteremia) and is carried to the meninges, joint spaces, bones, and peritoneal cavity, and may result in meningitis, brain abscess, septic arthritis, or osteomyelitis.
S. pneumoniae has several virulence factors, including the polysaccharide capsule mentioned earlier, that help it evade a host's immune system. It has pneumococcal surface proteins that inhibit complement-mediated opsonization, and it secretes IgA1 protease that will destroy secretory IgA produced by the body.