12&13: Acute and Chronic Inflammation

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Questions and Answers

Which type of inflammation is characterized by an exudate with strands and flecks of fibrin, often associated with a more significant inflammatory response compared to a watery fluid?

  • Suppurative inflammation
  • Fibrinous inflammation
  • Serous inflammation
  • Serofibrinous inflammation (correct)

What characteristics define mucoid or catarrhal inflammation?

  • An excess outpouring of mucus and epithelial debris, often found in respiratory or alimentary tracts. (correct)
  • A thick, creamy-white exudate composed mainly of dead neutrophils.
  • A straw-colored fluid with an increase in cells and protein that clots on air exposure.
  • White, flaky material that is often adherent to the tissue surface.

Which of the following best describes diphtheritic inflammation?

  • Characterized by the presence of serous fluid with a red tinge.
  • Characterized by large numbers of dead and dying neutrophils and necrotic tissue debris.
  • Characterized by a predominance of mononuclear cells
  • Characterized by a sticky, yellow-brown exudate forming a false membrane on the underlying surface. (correct)

Which of the following inflammatory types is characterized by increased numbers of red blood cells, causing the affected tissue to appear in varying shades of dull red, and is associated with significant damage to blood vessels?

<p>Haemorrhagic (A)</p> Signup and view all the answers

What primary process distinguishes chronic inflammation from acute inflammation?

<p>Cellular proliferation. (B)</p> Signup and view all the answers

Fibrosis, a common feature of chronic lesions, leads to what change in tissue appearance and texture?

<p>Areas that appear pale and firm (C)</p> Signup and view all the answers

Which of the following is a key characteristic of chronic inflammation?

<p>Accumulation of infiltrating leukocytes. (D)</p> Signup and view all the answers

What is the role of fibrosis in chronic abscessation?

<p>It walls off the lesion, aiding in healing and repair. (C)</p> Signup and view all the answers

What is the likely consequence if a chronic abscess ruptures into a blood vessel?

<p>Bacteremia, septicemia, and potentially death. (B)</p> Signup and view all the answers

Which of the following best defines a key feature of granulomatous inflammation?

<p>Predominance of macrophages, often forming nodules or masses. (D)</p> Signup and view all the answers

What indicates the presence of pyogranulomatous inflammation instead of granulomatous inflammation?

<p>The presence of neutrophils in addition to macrophages (A)</p> Signup and view all the answers

What is the significance of identifying Langhans giant cells in tissue samples?

<p>They are a characteristic feature of granulomatous inflammation, often associated with tuberculosis. (A)</p> Signup and view all the answers

What are the main characteristics of chronic diffuse granulomatous enteritis, also known as Johne's disease, in ruminants?

<p>Thickening and corrugation of the terminal ileum. (C)</p> Signup and view all the answers

Which of the following best describes the pathogenesis of lesions associated with Chlamydia?

<p>Intracellular parasitic infection leading to granulomatous/proliferative inflammation. (A)</p> Signup and view all the answers

What is a primary feature of serous inflammation?

<p>Fluid with an increase in cells and protein, often straw colored (D)</p> Signup and view all the answers

Which of the following distinguishes suppurative inflammation from other types of inflammation?

<p>It is characterized by a large number of dead and dying neutrophils. (C)</p> Signup and view all the answers

In chronic inflammation, the presence of plasma cells in a lesion typically indicates that the lesion is at least how old?

<p>At least 2 weeks (B)</p> Signup and view all the answers

What factors influence whether a chronic abscess will rupture?

<p>The interplay between the characteristics of the fibrous capsule and suppurative center. (E)</p> Signup and view all the answers

What cell types are commonly seen in chronic inflammation?

<p>Macrophages, lymphocytes, and plasma cells (B)</p> Signup and view all the answers

Which bacteria does Koch identified when he revolutionized our understanding of infectious diseases?

<p>Mycobacterium tuberculosis (C)</p> Signup and view all the answers

Which one of the following features is associated with the gross pathology of chronic lesions?

<p>Areas of swelling/ thickening/nodularity. (D)</p> Signup and view all the answers

What are some of the general characteristics of suppurative / purulent inflammation?

<p>An exudate composed of large numbers of dead and dying neutrophils and necrotic tissue debris, liquefied by the neutrophils. (A)</p> Signup and view all the answers

What common feature can contribute to chronic inflammation?

<p>Unresolved acute inflammation. (D)</p> Signup and view all the answers

An animal presents with a low-grade, persistent tissue injury that has been ongoing for several years. Microscopic examination reveals cellular proliferation but minimal hyperaemia or fluid exudation. Which type of inflammation is most likely occurring?

<p>Chronic inflammation (B)</p> Signup and view all the answers

In tissues affected by chronic inflammation, why might the affected areas appear pale and firm?

<p>Fibrosis (C)</p> Signup and view all the answers

What is a common term-ending to indicate inflammation?

<p>itis (B)</p> Signup and view all the answers

What two conditions may result from the fibrous capsule and degree of suppurative center in an abscess?

<p>Capsule rupture or Bateremia (D)</p> Signup and view all the answers

Which of the following conditions is an example of granulomatous inflammation caused by Mycobacterium tuberculosis?

<p>Tuberculosis (C)</p> Signup and view all the answers

What is the underlying immune process that results in the formation of granulomas?

<p>The sequestration of a persistent antigen by immune cells. (A)</p> Signup and view all the answers

Which of the following bacteria is most commonly known to cause "wooden tongue" in cattle?

<p>Actinobacillus lignieresii (D)</p> Signup and view all the answers

What is the primary etiological agent responsible for "lumpy jaw" in cattle?

<p>Actinomyces bovis (A)</p> Signup and view all the answers

What is a common disease resulting from granulomatous inflammation?

<p>Chronic granulomatous enteritis (D)</p> Signup and view all the answers

Which type of inflammation is characterized by a predominance of lymphocytes and plasma cells?

<p>Lymphoplasmacytic (A)</p> Signup and view all the answers

What is the typical host response to bacteria that multiply only within eukaryotic cells?

<p>Granulomatous/proliferative inflammation in affected tissue (D)</p> Signup and view all the answers

Which bacterial agent is responsible for Chlamydiosis?

<p>Chlamydia psittaci (B)</p> Signup and view all the answers

An avian necropsy reveals splenomegaly, hepatomegaly, enteritis, polyserositis, and conjunctivitis. Which of the following agents is most likely responsible for these findings?

<p>Chlamydia psittaci (B)</p> Signup and view all the answers

Which test is most commonly used to diagnosis Chlamydiosis in live animals??

<p>Choanal &amp; cloacal Ag screening, ELISA, PCR (B)</p> Signup and view all the answers

What are some typical signs in birds infected with Chlamydia??

<p>All of the above (E)</p> Signup and view all the answers

Which of the following best describes the role of fibrin in fibrinous inflammation?

<p>It localizes the lesion and acts as a scaffold for cell migration and healing. (C)</p> Signup and view all the answers

What is the primary source of the viscous nature of exudate seen in mucoid or catarrhal inflammation?

<p>An excess outpouring of mucus and epithelial debris. (A)</p> Signup and view all the answers

How does haemorrhagic inflammation distinctly manifest in affected tissues?

<p>The tissue shows varying shades of dull red due to increased red blood cells. (D)</p> Signup and view all the answers

What best describes the formation of the 'false membrane' characteristic of diphtheritic inflammation?

<p>The result of fibrin exudation mixing with necrosis of the surface. (A)</p> Signup and view all the answers

What distinguishes chronic inflammation from acute inflammation regarding the presence of hyperaemia and fluid exudation?

<p>Chronic inflammation typically does not contain hyperaemia and fluid exudation as a primary feature. (D)</p> Signup and view all the answers

What are the three main features of chronic inflammation?

<p>Accumulations of infiltrating leukocytes, proliferation of granulation tissue, and proliferation of parenchyma. (D)</p> Signup and view all the answers

How does fibrosis affect the gross appearance of tissues affected by chronic lesions?

<p>Results in areas that appear pale and firm. (D)</p> Signup and view all the answers

Fibrous encapsulation is equal to what?

<p>Sequestration (A)</p> Signup and view all the answers

What is the likely progression of events in a chronic abscess that contains liquefaction and bacterial fermentation?

<p>Increased internal pressure, potentially leading to rupture. (C)</p> Signup and view all the answers

In cases where an abscess ruptures into a blood vessel, what is the most severe potential consequence?

<p>Bacteraemia, septicaemia, or death. (C)</p> Signup and view all the answers

How does the predominance of macrophages influence the classification of granulomatous inflammation?

<p>It categorizes the condition as granulomatous or histiocytic inflammation. (C)</p> Signup and view all the answers

What is the key cellular component that distinguishes pyogranulomatous inflammation from granulomatous inflammation?

<p>Additional presence of neutrophils. (C)</p> Signup and view all the answers

What characteristic feature is associated with a laminated layers of fibrous encapsulation & inspissated pus?

<p>Caseous Lymphadenitis (CLA) (C)</p> Signup and view all the answers

What types of cells are considered mononuclear?

<p>Macrophages, Lymphocytes and Plasma cells (B)</p> Signup and view all the answers

In serous inflammation, what happens when the fluid is tinged with blood?

<p>The fluid is then classified as serosanguineous (B)</p> Signup and view all the answers

Why can abscesses be both beneficial and detrimental to the host?

<p>They wall off the infectious agent but can also provide a favorable environment for the organism. (A)</p> Signup and view all the answers

Which of the following best describes how resolution occurs following acute inflammation?

<p>The damage is neutralized, and tissue damage is minimal. (A)</p> Signup and view all the answers

How does the host typically respond to bacteria that multiply only within eukaryotic cells?

<p>By forming granulomas. (A)</p> Signup and view all the answers

What is the role of soluble antimicrobial substances in mucoid or catarrhal inflammation?

<p>To stimulate cilia. (A)</p> Signup and view all the answers

Which type of pericarditis is associated with 'bread and butter' exudates?

<p>Fibrinous pericarditis. (B)</p> Signup and view all the answers

What does the presence of plasma cells typically indicate about a chronic lesion?

<p>The legion is at least 2 weeks old. (D)</p> Signup and view all the answers

Which feature is MOST likely to be observed on gross pathology of chronic lesions?

<p>Areas of swelling/thickening/nodularity (D)</p> Signup and view all the answers

What is the primary component of pus in suppurative or purulent inflammation?

<p>Dead neutrophils. (B)</p> Signup and view all the answers

Which of the following best describes the composition of the exudate in suppurative inflammation?

<p>An exudate composed of large numbers of dead and dying neutrophils and necrotic tissue debris. (C)</p> Signup and view all the answers

What is a key distinction between 'Obligate' and 'Facultative' intracellular bacteria?

<p>Obligate bacteria multiply only within eukaryotic cells, while facultative bacteria can survive intracellularly or extracellularly. (D)</p> Signup and view all the answers

What type of acute inflammation is characterized by fluid similar to serum with an increase in in cells and protein and clots on exposure to air?

<p>Serous inflammation (D)</p> Signup and view all the answers

What is the primary process by which chronic inflammation develops from unresolved acute inflammation?

<p>Progression without a typical &quot;acute phase&quot;. (C)</p> Signup and view all the answers

Which of the following is a charactistic of Mucoid / Catarrhal Inflammation?

<p>All of the above (D)</p> Signup and view all the answers

What refers to 'Suppurative, Purulent, Pustular, Neutrophilic' chronic inflammation?

<p>Neutrophils (B)</p> Signup and view all the answers

Bovine actinobacillosis is associated with what inflammatory condition?

<p>Wooden tongue (D)</p> Signup and view all the answers

What is the best description of where Mucoid / Catarrhal Inflammation occurs?

<p>Respiratory or alimentary tracts (B)</p> Signup and view all the answers

If neutrophiles are also present in Granulomatous Inflammation it is called?

<p>Pyogranuloma formation (D)</p> Signup and view all the answers

What best describes Healing by repair following acute inflammation?

<p>Damage neutralised but with tissue destruction (C)</p> Signup and view all the answers

What is the description of gross descriptor Diphtheritic

<p>Sticky, yellow- brown exudate adherent to underlying surface forming a false membrane (A)</p> Signup and view all the answers

Which of the following terms best describes inflammation when macrophages predominate and are disseminated throughout the lesion?

<p>Granulomatous (B)</p> Signup and view all the answers

What is the most severe potential consequence of bacteria released from ruptured pulmonary?

<p>Haemoptysis &amp; epistaxis (A)</p> Signup and view all the answers

What is the purpose of Abscesses in the host?

<p>Protect the host by walling off the agent (B)</p> Signup and view all the answers

What type of inflammatory cell is related to Lymphoplasmacytic?

<p>Lymphocytes &amp; Plasma cells (A)</p> Signup and view all the answers

Name a cause of Chronic diffuse granulomatous enteritis

<p>Mycobacterium avium subspecies paratuberculosis (A)</p> Signup and view all the answers

What kind of bacteria is Corynebacterium?

<p>Facultative Intracellular Bacteria (A)</p> Signup and view all the answers

What diseases falls under granulomas?

<p>Tuberculosis (A)</p> Signup and view all the answers

How does serofibrinous inflammation differ from serous inflammation?

<p>Serofibrinous inflammation is characterized by an exudate containing strands and flecks of fibrin, indicating a greater inflammatory response compared to the fluid in serous inflammation. (A)</p> Signup and view all the answers

In the context of fibrinous inflammation, what role does fibrin deposition play in the affected tissue?

<p>Fibrin serves as a scaffold for cell migration and promotes lesion localization, contributing to tissue repair. (C)</p> Signup and view all the answers

How do the environmental conditions within an abscess potentially counteract the host's immune response?

<p>The low pH and reduced oxygen levels within an abscess can impair neutrophil function and interfere with antibiotic penetration. (C)</p> Signup and view all the answers

How does the gross pathology of chronic lesions differ from that of acute lesions, particularly concerning tissue texture and appearance?

<p>Chronic lesions are typically characterized by areas of swelling, thickening, or nodularity with pale and firm texture due to fibrosis, while acute lesions show more pronounced redness and edema. (B)</p> Signup and view all the answers

What is the significance of identifying acid-fast bacteria within macrophages during histological examination?

<p>It suggests the presence of a granulomatous inflammation, potentially caused by mycobacterial infection. (B)</p> Signup and view all the answers

During the pathogenesis of Chlamydiosis, what cellular mechanisms does Chlamydia utilize to ensure its survival and replication within the host cell?

<p>Chlamydia prevents the fusion of the endosome containing it with lysosomes, thus avoiding degradation and enabling replication. (B)</p> Signup and view all the answers

In the context of chronic inflammation, how does fibrous encapsulation contribute to the persistence of a lesion?

<p>Fibrous encapsulation isolates the affected area, preventing immune cells and antibiotics from reaching the site of infection. (B)</p> Signup and view all the answers

What feature is associated with a Corynebacterium pseudotuberculosis infection?

<p>Laminated layers of fibrous encapsulation &amp; inspissated pus. (A)</p> Signup and view all the answers

How does the cellular composition typically differ between granulomatous and pyogranulomatous inflammation?

<p>Granulomatous inflammation is characterized by a predominance of macrophages, while pyogranulomatous inflammation contains both macrophages and neutrophils. (A)</p> Signup and view all the answers

How does chronic inflammation typically differ from acute inflammation in terms of vascular changes?

<p>Chronic inflammation typically does not contain hyperaemia and fluid exudation as a primary feature, in contrast to acute inflammation. (A)</p> Signup and view all the answers

Flashcards

Serous Inflammation

A response involving serous fluid, with increased cells and protein; often straw-colored and clots on air exposure.

Serofibrinous Inflammation

Similar to serous inflammation but containing strands and flecks of fibrin.

Fibrinous Inflammation

Fibrin deposits are often white, flaky, and adherent to the tissue, sometimes described as "bread and butter" exudates.

Mucoid/Catarrhal Inflammation

Excessive outpouring of mucus and epithelial debris, often seen in respiratory or alimentary tracts; appears viscous and pale yellow.

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Haemorrhagic Inflammation

Characterized by increased numbers of red blood cells, appearing in varying shades of dull red, associated with extensive vessel damage.

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Suppurative / Purulent Inflammation

Exudate composed of dead and dying neutrophils, necrotic tissue debris, liquefied by neutrophils, often bacterial, thick and creamy-white, yellow, green or brown

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Diphtheritic Inflammation

Characterized by sticky, yellow-brown exudate adherent to the underlying surface, forming a false membrane due to fibrin and necrosis.

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Chronic Inflammation

Results from unresolved acute inflammation or a slow, smoldering insult; often proliferative.

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Abscess

A localized collection of pus (dead neutrophils) in tissues; it protects the host by walling off the agent.

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Granulomatous Inflammation

Macrophages predominate in sheets or disseminated throughout the lesion.

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Pyogranulomatous Inflammation

Macrophages and Neutrophils are both present.

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Lymphoplasmacytic inflammation

An inflammation mediated by lymphocytes and plasma cells

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Actinobacillus lignieresii

Common bacterial etiological agent of Wooden Tongue

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Actinomyces bovis

Common bacterial etiological agent of Lumpy Jaw

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Chlamydia psittaci

Important avian pathogen that causes polyserositis, enteritis, splenomegaly and hepatomegaly

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Study Notes

  • Inflammation can be acute or chronic

Acute Inflammation

  • Serous
  • Serofibrinous
  • Fibrinous
  • Haemorrhagic
  • Suppurative/Purulent
  • Mucoid/Catarrhal
  • Diphtheritic
  • Termed 'Exudative'.

Chronic Inflammation

  • Granulomatous
  • Pyogranulomatous
  • Lymphocytic
  • Lymphoplasmacytic
  • Termed 'Proliferative'

Terminology

  • Add '-itis' to the end of a term to denote inflammation.
  • Stomatitis
  • Glossitis
  • Dermatitis
  • Pancreatitis
  • Otitis externa, media and/or interna
  • Ophthalmitis, uveitis, retinitis and/or keratitis
  • Pharyngitis
  • Encephalitis
  • Ingluvitis
  • Gastritis
  • Myocarditis
  • Pleuritis

Serous Inflammation

  • Features serous fluid (serum) with an increase in cells and protein
  • Straw coloured
  • Clots on exposure to air
  • Present in serous cavities
  • Is the initial exudate in most inflammatory lesions
  • Promotes dilution and facilitates migration
  • Serosanguineous is serous inflammation tinged with blood

Serofibrinous

  • Similar to serous inflammation
  • Contains strands and flecks of fibrin
  • Associated with a greater inflammatory response

Fibrinous Inflammation

  • Fibrin deposits are white and flaky, often adherent to the tissue
  • Produces "bread and butter" exudates
  • Localizes the lesion and is a scaffold for cell migration and healing
  • May be so severe that it is more dangerous than the initial injury, like in fibrinous pericarditis

Mucoid / Catarrhal Inflammation

  • An excess outpouring of mucus and epithelial debris from mucous membranes
  • Occurs in respiratory or alimentary tracts
  • Viscous and often pale yellow in color
  • Contains soluble antimicrobial substances
  • Stimulates cilia

Haemorrhagic Inflammation

  • Marked by increased numbers of red blood cells
  • Appears in varying shades of dull red
  • Is associated with inflammation and extensive damage to blood vessels

Suppurative / Purulent Inflammation

  • Consists of an exudate with many dead and dying neutrophils, plus necrotic tissue debris, liquefied by the neutrophils
  • Pus = dead neutrophils
  • Often the result of bacterial infections
  • Thick, creamy-white color
  • Can also be yellow, green or brown

Diphtheritic Inflammation

  • A gross descriptor
  • Characterized by sticky, yellow-brown exudate adherent to the underlying surface, forming a false membrane
  • Results from fibrin exudation mixing with necrosis of the surface, usually a mucous membrane
  • Also known as pseudomembranous

Chronic Inflammation

  • Can result from unresolved acute inflammation
  • May also result from a slow, smoldering insult without a typical "acute phase", such as mycobacterial infections
  • Characterized as proliferative
  • A chronic reaction involves low-grade tissue injury over a long period of time
  • Does not typically contain hyperaemia and fluid exudation as a primary feature
  • Cellular proliferation is often prominent

Three main features of chronic inflammation

  • Accumulations of infiltrating leukocytes
  • Proliferation of granulation tissue
  • Proliferation of parenchyma
  • Concurrent attempts at healing (regeneration, repair) coexisting with inflammation
  • Fibrous encapsulation = sequestration

Gross Pathology of Chronic Lesions

  • Areas of swelling, thickening, and/or nodularity
  • Fibrosis results in pale and firm areas
  • Cellular infiltration and proliferation lead to areas appearing pale with variable texture (firm to soft)
  • Concurrent tissue loss causes the organ to appear irregular and possibly shrunken

Chronic Inflammation Cell Types

  • The predominant cell types are mononuclear: macrophages, lymphocytes, plasma cells and fibroblasts
  • Other inflammatory cells may also be present (neutrophils & eosinophils)
  • Plasma cells are present if the lesion is at least 2 weeks old

Abscessation

  • Characterized by a sequestered suppurative exudate in tissues, called an abscess
  • Most bacterial invaders are killed intracellularly by leukocytes
  • Lytic action from trapped, dying neutrophils produces a liquid (thick, yellow-brown, foul-smelling) known as pus
  • Abscesses protect the host by walling off the agent
  • They may also benefit the infecting organism by providing favorable environmental conditions such as low pH and low O2 tension
  • These conditions decreases neutrophil functional ability and interferes with antibiotic penetration

Abscess Capsules

  • Fibrosis walls off a lesion that undergoes concurrent healing/repair and inflammation (collagen deposition)
  • Ongoing liquefaction and bacterial fermentation (gas) results in increased internal pressure
  • The strength of the fibrous capsule, and the intensity of the suppurative center determines whether the lesion ruptures
  • Rupture onto a surface (e.g. skin) may relieve pressure and enable fibrosis to resolve the lesion
  • Rupture into a vessel may lead to bacteraemia, septicaemia, or death

Granulomatous Inflammation

  • If macrophages predominate in sheets or are disseminated throughout a lesion, it is termed granulomatous or histiocytic inflammation
  • If neutrophils are also present it is called pyogranuloma formation and pyogranulomatous inflammation

Granulomas

  • Tubercle (Latin, small nodule/eminence)
  • Tuberculosis: Appears as many small nodules
  • Mycobacterium tuberculosis (humans) & M. bovis, cause "consumption"

Koch's Postulates

  • Established by Robert Koch's work on tuberculosis
  • The identified organism must (1) be present in all cases of the disease, (2) be isolated from diseased patients, (3) cause disease when reintroduced to a healthy susceptible animal model, and (4) then be isolated again from the new host.

Chronic Inflammation: Cell type association

  • Neutrophils are associated with suppurative, purulent, pustular and neutrophilic inflammation
  • Macrophages are associated with granulomatous and histiocytic inflammation
  • Lymphocytes are associated with lymphocytic inflammation
  • Lymphocytes & plasma cells are associated with lymphoplasmacytic inflammation
  • Eosinophils are associated with eosinophilic, pustular and suppurative inflammation
  • Neutrophils and macrophages are associated with pyogranulomatous inflammation

Examples of Infections

  • Actinobacillus lignieresii causes chronic glossitis in cattle
  • Actinomyces bovis causes mandibular osteomyelitis in cattle
  • Aspergillus terreus, in German Shepherd dogs
  • Johne's disease (Mycobacterium paratuberculosis) causes granulomatous jejunitis & typhlodicliditis

Chlamydiosis

  • Caused by Chlamydia psittaci
  • Can manifest as chlamydiosis in birds and psittacosis in humans
  • Commonly affects respiratory, ocular, hepatic & GIT systems
  • May result in sudden death
  • Other signs; Sinusitis, conjunctivitis, Sneezing, Serous oculonasal discharge, Dyspnoea, tail-bobbing, Green droppings, Anorexia & weightloss
  • Commonly causes splenomegaly, hepatomegaly, enteritis, polyserositis, and/or conjunctivitis
  • Diagnosed using choanal & cloacal Ag screening, ELISA, PCR
  • May also be diagnosed using necropsy spleen & liver impression smears and/or fluorescent antibody test (FAT)

Intracellular Bacteria

  • Facultative intracellular bacteria include; Pathogenic Staphylococcus, Rhodococcus equi, Corynebacterium sp., Listeria monocytogenes, Mycobacterium sp., Salmonella enterica, Brucella sp.
  • Obligate intracellular bacteria include; Lawsonia intracellularis, Rickettsia sp., Coxiella burnetii, Chlamydia sp., Chlamydophila sp and Mycoplasma sp.
  • Obligate bacteria multiply only within eukaryotic cells
  • Facultative bacteria survive intracellularly or extracellularly

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