Exudative inflammation: causes, types, outcomes
Every one of us experienced inflammation of one kind or another. And if its serious forms, for example pneumonia or colitis, are involved in special cases, then such minor problems as a cut or a scratch are common. Many do not pay attention to them at all. But even the most minor injuries can cause exudative inflammation. In fact, this is the state of the affected area in which specific fluids are collected in it, and then seep through the walls of the capillaries outwards. This process is rather complicated, based on the laws of hydrodynamics and capable of leading to complications of the course of the disease. In this article, we will discuss in detail what causes exudative inflammation of the cause. Species( the outcomes for each of them are unequal), we will also consider this kind of inflammatory processes, and in passing we will explain what they depend on, how they proceed, what treatment they require.
Inflammation is evil or good?
Many will say that, of course, inflammation is evil, because it is an integral part of almost any disease and brings a person suffering. But in fact, in the course of evolution, our body for many years developed in itself the mechanisms of inflammatory processes, so that they help to survive with harmful effects, in medicine called irritants. They can be viruses, bacteria, any injured skin, chemicals( eg poisons, toxins), unfavorable environmental factors. To protect us from the pathological activity of all these stimuli is precisely the exudative inflammation. What it is? If you do not delve into the details, explain it quite simply. Any stimulus, hitting the human body, damages its cells. This is called alternation. It gives rise to an inflammatory process. Its symptoms, depending on the type of stimulus and the site of its introduction, may differ. Among the general allocate:
- rise in temperature either in the whole body, or only in the damaged area;
- swelling of the sore spot;
- redness of the injured area.
These are the main signs by which one can understand that exudative inflammation has already begun. The photo above demonstrates the manifestation of symptoms - redness, swelling.
At some stage of the inflammatory process, liquids( exudate) begin to accumulate in the vessels. When they penetrate the walls of the capillaries into the intercellular space, the inflammation becomes exudative. At first glance it seems that this is an aggravation of the problem. But in fact, the exudate, or, as doctors say, exudation, is also needed. Thanks to it, very important substances come into the tissue from the capillaries: immunoglobulins, kinins, plasma enzymes, leukocytes, which immediately rush to the inflammation focus, to deal with the elimination of irritants and the healing of damaged areas.
Explaining what exudative inflammation is, the pathological anatomy( the discipline that deals with the study of pathological processes) pays special attention to the process of exudation, the "culprit" of this type of inflammation. It consists of three stages:
- There was an alteration. She launched into operation special organic compounds - mediators of inflammation( kinins, histamines, serotonin, lymphokines and others).Under their action, the channels of microvessels began to expand, and as a result, the permeability of the vessel walls increased.
- In the wider sections of the channels, the blood flow began to move more intensively. There was a so-called hyperemia, which, in turn, led to an increase in the blood vessels( hydrodynamic) pressure.
- Under the pressure of liquid from microvessels through the increased interendothelial cracks and pores, sometimes reaching the size of the tubules, exudate began to seep into the tissue. Particles, its components, moved to the focus of inflammation.
Types of exudates
It is more appropriate to call exudate fluid leaving the vessels in the tissues, and the same fluids released in the cavity - effusion. But in medicine, these two concepts are often combined. Exudative type of inflammation is determined by the composition of the secret, which can be:
- is fouled;
- is chylus-like;
- is neutrophilic;
- is eosinophilic;
- by lymphocyte;
Let us consider in more detail the most common types of exudative inflammation, its causes and symptoms.
Form of serous exudative inflammation
In the human body, the peritoneum, pleura, pericardium cover the serous membranes, so named from the Latin word "serum", which means "serum", because they produce and absorb fluids that resemble serum or formed from it. Serous membranes in the usual state are smooth, almost transparent, very elastic. When exudative inflammation begins, they become rough and cloudy, and exudates of serous character appear in the tissues and organs. It shows proteins( more than 2%), lymphocytes, leukocytes, epithelial cells.
The causes of exudative inflammation can become:
- traumas of various etiologies( skin integrity disorders, burns, insect bites, frostbite);
- viral and bacterial infections( tuberculosis, meningitis, herpes, chickenpox and others);
Serous exudate helps to remove toxins and irritants from the inflammatory focus. Along with its positive functions there are also negative ones. So, if serous exudative inflammation has arisen in the lung parenchyma, respiratory insufficiency may develop, in the pericardium - heart failure, in the cerebral membranes - cerebral edema, in the kidneys - renal failure, in the skin under the epidermis - flaking it from the dermis and the formation of serous blisters. Symptoms for each disease are different. Of the general, you can distinguish the rise in temperature and pain. Despite the seemingly very dangerous pathology, the prognosis in the vast majority of cases is favorable, since the exudate resolves without leaving traces, and the serous membranes are restored.
Fibrous inflammation of
As noted above, all types of exudative inflammation are determined by the secretion, which is released from microvessels. Thus, fibrous exudate is obtained when an increased amount of fibrinogen protein is formed under the action of irritants of inflammation( trauma, infection).Normally in an adult, it should be 2-4 g / l. In damaged tissues this substance turns into fibrin. This is also a protein that has a fibrous structure and forms the basis of blood clots. In addition, fibrotic exudate has leukocytes, macrophages, monocytes. At some stage of inflammation develops necrosis affected by tissue irritant. They are impregnated with fibrous exudate, as a result of which a fibrous film forms on their surface. Under it, microbes are actively developing, which complicates the course of the disease. Depending on the localization of the film and its features, distinguish between diphtheric and croupous fibrosis exudative inflammation. Pathological anatomy describes their differences in this way:
- Diphtheric inflammation can occur in those organs that are covered with a multilayered membrane - in the throat, uterus, vagina, bladder, GIT organs. In this case, the fibrous film forms a thick, as if ingrown into the shell of the organs. Therefore it is removed it is difficult, and after itself leaves ulcers. Over time, they heal, but scars can stay. There is another evil - under this film the microbes reproduce most actively, as a result of which the patient has a high intoxication with the products of their vital activity. The most famous disease of this type of inflammation is diphtheria.
- Croupous inflammation is formed on the mucous organs, covered with a single-layered membrane: in the bronchi, peritoneum, trachea, pericardium. In this case, the fibrous film is thin, easily removable, without significant mucosal defects. However, in some cases, it can create serious problems, for example, with inflammation of the trachea can make it difficult to get air into the lungs.
Exudative purulent inflammation of
This pathology is observed when the exudate is pus - a viscous greenish-yellow mass, which in most cases has a characteristic odor. Its composition is approximately the following: leukocytes, most of which are destroyed, albumins, fibrin filaments, microbial origin enzymes, cholesterol, fats, DNA fragments, lecithin, globulins. These substances form a purulent serum. In addition to her, in purulent exudate there are tissue detritus, living and / or degenerated microorganisms, purulent bodies. Purulent inflammation can occur in any organs."The culprits" of suppuration are most often pyogenic bacteria( various cocci, intestinal sticks, proteins), as well as Candida, Shigella, Salmonella, Brucella. Forms of exudative inflammation of a purulent nature are as follows:
- Abscess. It is a center with a barrier capsule, which prevents pus from entering adjacent tissues. In the cavity of the focus, purulent exudate accumulates, which enters through the capillaries of the barrier capsule.
- Phlegmon. With this form, the focus of inflammation has no clear boundaries, and purulent exudate spreads into adjacent tissues and cavities. Such a picture can be observed in the subcutaneous layers, for example, in adipose tissue, in the retroperitoneal and perineal zones, wherever the morphological structure of the tissues allows pus to go beyond the inflammatory focus.
- Empyema. This form is similar to an abscess and is observed in the cavities next to which there is a focus of inflammation.
If there is a lot of degenerative neutrophils in the pus, the exudate is called purulent neutrophil. In general, the role of neutrophils lies in the destruction of bacteria and fungi. They, like brave guardians, are the first to rush at the enemies who have penetrated into our body. Therefore, at the initial stage of inflammation, most neutrophils are whole, undisturbed, and exudate is called micro-nasal. As the disease progresses, the leukocytes are destroyed, and in the pus, most of them are already degenerated.
If putrefactive microorganisms get into the inflammatory focus( in most cases anaerobic bacteria), the purulent exudate grows into putrefactive. It has a characteristic smell and color and promotes the decomposition of tissues. It is fraught with high intoxication of the body and has a very unfavorable outcome.
Treatment of purulent inflammation is based on the use of antibiotics and ensuring the outflow of secret from the source. Sometimes this requires surgical intervention. Prevention of such inflammation is disinfection of wounds. Treatment of this pathology can have a favorable outcome only with intensive chemotherapy with simultaneous surgical removal of rotting fragments.
Hemorrhagic inflammation of
With some very dangerous diseases, such as anthrax, black pox, plague, toxic flu, hemorrhagic exudative inflammation is diagnosed. Its causes consist in the increasing permeability of microvessels up to their discontinuities. In the exudate, erythrocytes predominate, so that its color varies from pink to dark red. The external manifestation of hemorrhagic inflammation is similar to hemorrhage, but unlike the latter, not only erythrocytes but also a small fraction of neutrophils with macrophages are found in the exudate. Treatment of hemorrhagic exudative inflammation is appointed taking into account the type of microorganisms that led to it. The outcome of the disease can be extremely unfavorable if therapy is started untimely and if the patient's body does not have enough strength to resist the disease.
Catarrhal inflammation of
The peculiarity of this pathology is that exudate with it can be serous, purulent, and hemorrhagic, but necessarily with mucus. In such cases, a mucous secret is formed. Unlike serous, it shows more mucin, antibacterial agent lysozyme and A-class immunoglobulins. It is formed for the following reasons:
- infections are viral or bacterial;
- effect on the body of chemicals, high temperatures;
- disorders in metabolism;
- allergic reactions( eg, allergic rhinitis).
Catarrhal exudative inflammation is diagnosed in bronchitis, catarrh, rhinitis, gastritis, catarrhal colitis, ARI, pharyngitis and can occur in acute and chronic forms. In the first case, it is completely cured within 2-3 weeks. In the second there are changes in the mucosa - atrophy, in which the shell is thinned, or hypertrophy, in which, on the contrary, the mucosa becomes thickened and can protrude into the cavity of the organ.
The role of mucous exudate is twofold. On the one hand, it helps fight infection, and on the other, its accumulation in cavities leads to additional pathological processes, for example, mucus in the sinuses of the nose contributes to the development of sinusitis.
Treatment of catarrhal exudative inflammation is carried out by antibacterial drugs, physiotherapy procedures and folk methods, such as warming up, rinsing with various solutions, ingestion of infusions and decoctions of herbs.
Exudative inflammation: a characteristic of specific exudative fluids
The above mentioned chyleic and pseudo-cholesteric exudates that appear in traumas of lymphatic vessels. For example, in the chest it can be with the rupture of the thoracic duct. Chylezny exudate in color white because of the presence of an increased amount of fat in it.
Pseudo-chyle also has a whitish hue, but fat in it is not more than 0.15%, but there are mucoid substances, protein bodies, nucleic acids, lecithins. It is observed with lipid nephrosis.
White color and chillus-like exudate, only the color is given to the decomposed degenerate cells. It is formed during chronic inflammation of serous membranes. In the abdominal cavity it happens with cirrhosis of the liver, in the pleural cavity - with tuberculosis, pleura cancer, syphilis.
If there are too many lymphocytes in the exudate( more than 90%), it is called lymphocyte. It is excreted from the vessels in pleural tuberculosis. If the secret is cholesterol, by analogy it is called cholesterol. It has a thick consistency, yellowish or brownish color and can be formed from any other exudative fluid, provided that from the cavity in which it accumulates for a long time, there is a reverse absorption of water and mineral particles.
As you can see, there are many types of exudates, each of which is typical for a particular type of exudative inflammation. There are also cases where mixed exudative inflammation is diagnosed in any one disease, for example, serous-fibrous or serous-purulent.
Acute and chronic forms of
Exudative inflammation can occur in acute or chronic form. In the first case, it is an instant response to the stimulus and is intended to eliminate this stimulus. The reasons for this form of inflammatory process can be very much. The most common:
- chemical poisoning;
- violations of any organs and systems.
Acute exudative inflammation is characterized by reddening and swelling of the injured area, pain, and fever. Sometimes, especially due to infection, patients have symptoms of vegetative disorders and intoxication.
Acute inflammation occurs relatively briefly, and if the therapy is performed correctly, it is completely cured.
Chronic exudative inflammation can last for years. It is represented by purulent and catarrhal types of the inflammatory process. In this case, simultaneously with healing, the destruction of tissues develops. And although the chronic inflammation of the patient does not disturb almost at the stage of remission, it eventually can lead to depletion( cachexia), sclerotic changes in the vessels, irreversible disruption of the organs and even the formation of tumors. The treatment is mainly aimed at maintaining the remission phase. In this case, great importance is attached to the right way of life, diet, strengthening of immunity.