With inflammation of one kind or another, each of us faced. And if its serious forms, such as pneumonia or colitis, occur in special cases, then such minor troubles as a cut or abrasion are commonplace. Many do not pay attention to them at all. But even the most minor injuries can cause exudative inflammation. In fact, this is such a condition of the affected area, in which specific fluids collect in it, and then leak out through the walls of the capillaries. This process is quite complex, based on the laws of hydrodynamics and capable of leading to complications of the course of the disease. In this article, we will analyze in detail what causes exudative inflammation. Types (outcomes for each of them are unequal) of this kind of inflammatory processes will also be considered, and along the way we will explain what they depend on, how they proceed, what treatment is required.
Is inflammation evil or good?
Many will say that, of course, inflammation is evil, because it is an integral part of almost any disease and brings suffering to a person. But in fact, in the process of evolution, our body for many years developed the mechanisms of inflammatory processes in itself, so that they help to survive the harmful effects, in medicine called irritants. They can be viruses, bacteria, any skin injuries, chemicals (for example, poisons, toxins), adverse environmental factors. Exudative inflammation should protect us from the pathological activity of all these irritants. What it is? If you do not go into details, explaining it is quite simple. Any irritant, once in the human body, damages his cells. This is called alteration. It gives rise to the inflammatory process. Its symptoms, depending on the type of stimulus and the place of its introduction, may vary. Among the common ones are:
- temperature rise either in the whole body, or only in the damaged area;
- swelling of the sore spot;
- soreness;
- redness of the injured area.
These are the main signs by which you 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 , fluids begin to accumulate in the vessels (exudate). When they penetrate through the walls of the capillaries into the intercellular space, inflammation becomes exudative. At first glance, it seems that this is an aggravation of the problem. But in fact, the exit of exudate, or, as doctors say, exudation is also needed. Thanks to it, very important substances get into the tissues from the capillaries - immunoglobulins, kinins, plasma enzymes, leukocytes, which immediately rush to the site of inflammation to deal with the elimination of irritants and the healing of damaged areas.
Exudation process
Explaining what exudative inflammation is, pathological anatomy (a discipline that studies pathological processes) pays special attention to the process of exudation, the “culprit” of this type of inflammation. It consists of three stages:
- Alteration has occurred. She launched special organic compounds - inflammatory mediators (kinins, histamines, serotonins, lymphokines and others). Under their action, the bed of microvessels began to expand, and as a result, the permeability of the walls of the vessels increased.
- In 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 blood vessels (hydrodynamic) pressure.
- Under the pressure of fluid from microvessels, exudate began to seep into the tissue through increased interendothelial fissures and pores, sometimes reaching the size of the tubules. Particles, its components, moved to the focus of inflammation.
Types of exudates
It is more correct to call exudate the fluids that leave the vessels in the tissue, and the same fluids that are released in the cavity are called effusion. But in medicine, these two concepts are often combined. The exudative type of inflammation is determined by the composition of the secret, which can be:
- serous;
- fibrous;
- purulent;
- putrid;
- hemorrhagic;
- mucous membranes;
- chylous;
- hylus-like;
- pseudochilous;
- cholesterol;
- neutrophilic;
- eosinophilic;
- lymphocytic;
- mononuclear;
- mixed.
Consider in more detail the most common types of exudative inflammation, its causes and symptoms.
The form of serous exudative inflammation
In the human body, the peritoneum, pleura, pericardium are covered by serous membranes, so called from the Latin word “serum”, which means “serum”, because they produce and absorb liquids that resemble or form blood serum. Serous membranes in the normal state are smooth, almost transparent, very elastic. When exudative inflammation begins, they become rough and cloudy, and exudate of a serous nature appears in tissues and organs. It contains proteins (more than 2%), lymphocytes, white blood cells, epithelial cells.
The causes of exudative inflammation can be:
- injuries of various etiologies (violation of the integrity of the skin, burns, insect bites, frostbite);
- intoxication;
- viral and bacterial infections (tuberculosis, meningitis, herpes, chickenpox and others);
- allergy.
Serous exudate helps to remove toxins and irritants from the site of inflammation. Along with its positive functions, there are also negative ones. So, if serous exudative inflammation arose in the lung parenchyma, respiratory failure can develop, heart failure in the pericardium, cerebral edema in the brain membranes, renal failure in the kidneys, and peeling from the dermis in the skin under the epidermis and the formation of serous blisters. Symptoms for each disease are different. Of the general, one can distinguish a rise in temperature and pain. Despite the seemingly very dangerous pathology, the prognosis in the vast majority of cases is favorable, since the exudate dissolves without leaving traces, and the serous membranes are restored.
Fibrotic inflammation
As already noted above, all types of exudative inflammation are determined by the composition of the secretion, when they are secreted from microvessels. So, fibrous exudate is obtained when an increased amount of fibrinogen protein is formed under the action of inflammation irritants (trauma, infection). Normally, an adult should have 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, in fibrous exudate there are white blood cells, macrophages, monocytes. At some stage of inflammation, necrosis of the tissues affected by the stimulus develops. 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, diphtheria and croupous fibrous exudative inflammation are distinguished. Pathological anatomy describes their differences in this way:
- Diphtheria inflammation can occur in those organs that are coated with a multilayer membrane - in the pharynx, uterus, vagina, bladder, and digestive tract organs. In this case, the fibrous film is formed thick, as if ingrown into the membrane of organs. Therefore, it is difficult to remove, and after itself leaves ulcers. Over time, they heal, but scars may remain. There is another evil - under this film, microbes multiply 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 mucous membranes coated with a single layer: in the bronchi, peritoneum, trachea, pericardium. At the same time, the fibrous film turns out to be thin, removable easily, without significant mucosal defects. However, in some cases, it can create serious problems, for example, with inflammation of the trachea, air can enter the lungs.
Exudative suppurative inflammation
This pathology is observed when the exudate is pus - a viscous greenish-yellow mass, in most cases having a characteristic odor. Its composition is approximately the following: leukocytes, most of which are destroyed, albumin, fibrin filaments, enzymes of microbial origin, cholesterol, fats, DNA fragments, lecithin, globulins. These substances form purulent serum. In addition to it, purulent exudate contains 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, Escherichia coli, Proteus), as well as candida, shigella, salmonella, and brucella. Forms of exudative inflammation of a purulent nature are as follows:
- Abscess. It is a focus with a barrier capsule that prevents pus from entering neighboring tissues. Purulent exudate accumulates in the cavity of the focus, entering through the capillaries of the barrier capsule.
- Phlegmon. With this form, the focus of inflammation does not have clear boundaries, and purulent exudate spreads into neighboring tissues and cavities. Such a picture can be observed in the subcutaneous layers, for example, in adipose tissue, in the retroperitoneal and perinephric zones, wherever the morphological structure of the tissues allows pus to go beyond the focus of inflammation.
- Empyema. This form is similar to an abscess and is observed in cavities, next to which there is a focus of inflammation.
If there are many degenerative neutrophils in the pus, the exudate is called purulent neutrophil. In general, the role of neutrophils is to kill bacteria and fungi. They, like brave guards, are the very first to rush at the enemies that have penetrated our body. Therefore, at the initial stage of inflammation, most neutrophils are intact, intact, and the exudate is called microcultural. As the disease progresses, the white blood cells are destroyed, and in the pus, most of them are already degenerated.
If putrefactive microorganisms (in most cases anaerobic bacteria) get into the inflammatory focus, the purulent exudate develops into putrefactive. It has a characteristic odor and color and promotes the decomposition of tissues. This 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 providing an outflow of secretion from the focus. Sometimes this requires surgical intervention. Prevention of such inflammation is wound disinfection. Treatment of this pathology can have a favorable outcome only with intensive chemotherapy with simultaneous surgical removal of rotting fragments.
Hemorrhagic inflammation
With some very dangerous diseases, such as anthrax, blackpox, plague, toxic flu, hemorrhagic exudative inflammation is diagnosed. Its causes are the increasing permeability of microvessels up to their ruptures. In this case, red blood cells predominate in the exudate, due to which its color varies from pink to dark red. The external manifestation of hemorrhagic inflammation is similar to hemorrhage, but, unlike the latter, not only red blood cells are found in the exudate, but also a small proportion of neutrophils with macrophages. Treatment of hemorrhagic exudative inflammation is prescribed taking into account the type of microorganisms that led to it. The outcome of the disease can be extremely unfavorable if therapy is started late and if the patient’s body does not have enough strength to resist the disease.
Catarrh
A feature of this pathology is that exudate with it can be serous, and purulent, and hemorrhagic, but necessarily with mucus. In such cases, a mucous secret is formed. Unlike serous, it reveals more mucin, an antibacterial agent of lysozyme and A-class immunoglobulins. It is formed for the following reasons:
- viral or bacterial infections;
- exposure to chemicals, high temperatures;
- metabolic disorders;
- allergic reactions (e.g. allergic rhinitis).
Catarrhal exudative inflammation is diagnosed with bronchitis, catarrh, rhinitis, gastritis, catarrhal colitis, acute respiratory infections, pharyngitis and can occur in acute and chronic forms. In the first case, it is completely cured in 2-3 weeks. In the second, changes in the mucosa occur - atrophy, in which the membrane becomes thinner, or hypertrophy, in which, on the contrary, the mucosa becomes thickened and can protrude into the cavity of the organ.
The role of the mucous exudate is twofold. On the one hand, it helps to fight the infection, and on the other, its accumulation in the cavities leads to additional pathological processes, for example, mucus in the sinuses of the nose promotes the development of sinusitis.
Treatment of catarrhal exudative inflammation is carried out with antibacterial drugs, physiotherapeutic procedures and alternative methods, such as heating, rinsing with various solutions, ingestion of infusions and decoctions of herbs.
Exudative inflammation: characterization of specific exudative fluids
Chylous and pseudochilous exudates appearing during injuries of lymphatic vessels were mentioned above. For example, in the chest it can be with a rupture of the thoracic duct. Chylous exudate is white in color due to the presence of an increased amount of fat in it.
Pseudochilus also has a whitish hue, but fat in it is not more than 0.15%, but there are mucoid substances, protein bodies, nucleins, lecithins. It is observed with lipoid nephrosis.
White in color and chylus-like exudate, only the decayed degenerate cells give color to it. It is formed in chronic inflammation of the serous membranes. In the abdominal cavity this happens with cirrhosis of the liver, in the pleural cavity - with tuberculosis, pleural cancer, syphilis.
If there are too many lymphocytes in the exudate (more than 90%), it is called lymphocytic. It is secreted from vessels in pleural tuberculosis. If cholesterol is present in secret, it is called cholesterol by analogy. 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 characteristic of a certain type of exudative inflammation. There are also cases when, with any one disease, mixed exudative inflammation is diagnosed, for example, serous-fibrous or serous-purulent.
Acute and chronic forms
Exudative inflammation can occur in acute or chronic form. In the first case, it is an instant response to a stimulus and is designed to eliminate this stimulus. The reasons for this form of the inflammatory process can be very many. Most common:
- injury
- infections
- chemical poisoning ;
- disruption of the work of any organs and systems.
Acute exudative inflammation is characterized by redness and swelling of the injured area, pain, fever. Sometimes, especially due to infection, patients have symptoms of autonomic disorders and intoxication.
Acute inflammation is relatively short, and if the therapy is carried out correctly, it is completely cured.
Chronic exudative inflammation can last for years. It is represented by purulent and catarrhal types of the inflammatory process. At the same time, tissue destruction develops along with healing. Although chronic inflammation of the patient is almost not worried in the remission stage, it can ultimately lead to exhaustion (cachexia), sclerotic changes in the vessels, irreversible disruption of the organs and even the formation of tumors. Treatment is mainly aimed at maintaining the phase of remission. In this case, great importance is attached to the correct lifestyle, diet, strengthening immunity.