Question

Tessa has always been unhappy with her nose. After graduating college and saving up for a few years, she wanted to have rhinoplasty. She consulted a plastic surgeon, and scheduled surgery during her annual vacation. A few days after surgery Tessa was changing the dressings of gauze on her nose when she noticed increased swelling and pain at the incision site. By the next day she had a fever above 100.4°F, and the infection appeared to have spread beyond just the site of incision. She went back to the surgery clinic, where they took a swab of pus from the infected area for culture and prescribed an antibiotic.

The next day the lab called to report that Tessa had a Staphylococcus aureus infection. The surgery and the nasal packing with gauze provided both an area for bacterial proliferation and an environment that contained air pockets giving the bacteria necessary amounts of oxygen for growth.

Staphylococcus aureus is a gram positive, nonmotile, catalase positive, coccus found on the outside of the body, especially around the nose. About 30% of the population carries S. aureus at any particular time, and about 2/3 of people are at least occasional carriers. Infection with this bacterium leads to localized inflammation, and eventually causes capillary endothelial cell damage which can give the bacteria access to the circulation. S. aureus produces an antiphagocytic capsule. Many strains of S. aureus produce exotoxins and some strains are antibiotic resistant. Fortunately for Tessa, the S. aureus infecting her nose did not produce toxic shock syndrome toxin or exfoliative toxin, and her infection responded quickly to antibiotics.

Arrange these steps in an inflammation reaction in the correct order

      -       1.       2.       3.       4.       5.       6.       7.      

Arrival of macrophages

      -       1.       2.       3.       4.       5.       6.       7.      

Clot fomation

      -       1.       2.       3.       4.       5.       6.       7.      

Formation of pus

      -       1.       2.       3.       4.       5.       6.       7.      

Exudate seepage

      -       1.       2.       3.       4.       5.       6.       7.      

Mast cells release chemokines

      -       1.       2.       3.       4.       5.       6.       7.      

Vasoconstriction

      -       1.       2.       3.       4.       5.       6.       7.      

Vasodilation

Answer 1

Inflammation is the body’s response to tissue cell damage or injury or exposure to irritants. It involves the immune system. Five classic signs of inflammation are redness, pain, swelling, warmth and loss of function.

The sequence of events of inflammatory process are :

1. Vasodilation

2. Mast cells release chemokines

3. Exudate seepage

4. Arrival of macrophages

5. Vasoconstriction

6. Pus formation

7. Clot formation