bacteria


Tonsils – Episode 110

An image of a caucasian child's mouth, open wide with their teeth, tongue, and uvula visible. This is representative of the way one may open wide for a doctor to inspect the tonsils and throat.

Tonsils Basics

Your tonsils can be found in the back of your throat.  You can open your mouth and look in the mirror and see them on each side of your mouth behind your teeth and tongue.  You can also feel them below your earlobes and behind your jaw bone.

Tonsils are composed of lymph tissue since they are a part of your lymph system.  They store white blood cells that help you fight off infection.  Their activation during sickness is why they swell and get sore.

They are covered with the same mucosal membrane as the rest of the inside of your mouth.  This mucosa layer has pits and crevices called crypts.  These crypts increase the surface area of the mucosa that comes in contact with the lymph tissue and allows more opportunity for infectious material to be directly accessed by the immune system.

Infectious Tonsil Issues

Tonsillitis is the inflammation of the tonsils.  It can be classified as acute or chronic.  Acute tonsillitis is directly related to a viral or bacterial infection.  Chronic tonsillitis can be either a persistent, long-lasting infection or multiple consecutive acute episodes that can appear to be one long sickness.

Swollen tonsils can cause simple activities such as swallowing, talking, and breathing very painful.  You can see your swollen tonsils when you look in the mirror.  They will appear red or possibly blistered.

Mono, an infection caused in adolescents and adults by the Epstein-Barr virus, cause severe swelling in all the lymph nodes, including the tonsils.  This is one of the situations where your tonsils will be so inflamed, you can see the swelling on the outside of your face and neck.  Because such a large portion of your lymph system is involved, including your spleen, this is a serious sickness.

Strep throat is probably the first infection you think about when you think of swollen tonsils.  The bacteria, streptococcus, infect the lining of the tonsils and throat.  This is why the doctor will swab your tonsils when they’re testing for strep.

Non-Infectious Tonsil Issues

A non-infectious reason the tonsils will be large is a condition caused hypertrophic tonsils.  The tonsil tissue and/or mucosa overgrow and become oversized without any infection or immune activation being involved.  Overgrown tonsil tissue can lead to snoring or sleep apnea, and that’s bad.

Another non-infectious issue with your tonsils is called tonsilloliths or tonsil stones.  These stones happen when dead bacteria or food debris gets stuck in the crypts and they become calcified.  They cause a sensation many describe as a crumb stuck in your throat.   They can become quite large and can interfere with swallowing and eustachian tube function.  Because the eustachian tubes run from your eardrum into your throat, if the tonsil is swollen enough, it may close off the tube to the ear and cause ear pressure/pain.  Some tonsil stones are large enough to be visible and may have to be manually removed.  Lastly, due to the composition of the stones (dead bacteria and old food), frequent tonsil stones can be the cause of bad breath.

There’s no way to prevent tonsil stones 100%.  Good oral hygiene can certainly help reduce the frequency of stones, and can also help remove them quickly if they occur.  The most common way of trying to remove a tonsil stone involve coughing, clearing your throat, or hissing.  All three of these ways produce vibrations in the lining of the throat and mouth.  So along with the exhalation of these methods, hopefully, the result is the stone coming out of the tonsil and out of your mouth.

PSA:  Please DO NOT scratch your tonsils with your fingernails to remove a tonsil stone!

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Meningitis [Show Notes]

Basics

Meningitis = inflammation of meninges

Generalized symptoms:  fever, headache, stiff neck, light sensitivity, confusion, lethargy, 

4 types of infectious meningitis

  1. Bacterial – we have a vaccine for that! 3-7 days; spreads in close communities (like college dorms).  Spreads through prolonged contact.  Confirmed through spinal tap and cerebrospinal fluid culture
  2. Viral – most common type; can be caused by lots of viruses: enterovirus, mumps, measles, flu, west nile.  7-10 days.  This is why I believe in vaccines!
  3. Fungal – not contagious; most common in patient with suppressed immune systems or secondary from surgery.
  4. Parasitic – Rare yet fatal.  Amoeba enters through nose from warm contaminated fresh water sources or pool, even hot springs (warm up to 115* F).  Only 31 cases in the 10 years between 2002 and 2012.  Destroys brain tissue ~ 5 days. 

Non-infectious causes:  Surgery, injury, lupus, cancer

The most important thing is that all of this be monitored by a doctor – ALWAYS!!

2 quick tests for meningitis

Kernig’s sign 

Brudzinski’s sign

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Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/


Punctures and Cellulitis [Show Notes]

Puncture Wound

A wound that is deep but a small point of entry (i.e. nail).   This allows the bacteria to get stuck inside.  Thus it won’t always bleed cuz the opening is too small for it to make it out.   So if the blood can’t get out, then antibiotic ointments can’t get in.

Signs of Infection

  • Swelling
  • Redness
  • Pain
  • Warm
  • “Lumpy” or “Dimpled”
  • Oozing
  • “Running” or “crawling” veins

Lockjaw anyone?  Tetanus is an opportunistic infection that gets into the body from dirty objects and then causes muscle rigidity (among other things).  It is very easy to prevent with a booster shot.

Cellulitis is not the same as cellulite, but does affect the same layer of the skin! It’s an infection caused by the normal bacteria that live on your skin.  As long as it’s on your skin – cool, we’re friends.  If it gets in your skin – that’s trouble.  Staph or strep – friends on the outside, enemies on the inside.  Requires oral antibiotics, and sometimes, even IV antibiotics.

Necrotizing fasciitis – bacterial infection gets so deep into the skin layers that it starts eating away the dermis and muscles below it.

Risks for Cellulitis

  • surgical sites
  • cuts and abrasions
  • puncture wounds!!!!
  • skin ulcers (from prosthetics, wheelchairs, or being bedridden)
  • spider and insect bites (bugs aren’t sterile, plus toxins – ick!)
  • cracked dry skin
  • hangnails
  • athlete’s foot (skin changes, including cracking)

Takeaway

Puncture wounds should not be treated at home – especially if you were stuck by something dirty.

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Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

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Liver Lesson #6: Immunity [Show Notes]

Let’s Review

Liver contributes to:

1. Digesting your food

2. Metabolizing the energy from your food

3. Storage of Vitamins

4. Detoxing waste and toxins from your blood

5. Production of factors involved in blood clotting

Lastly, your liver keeps your healthy by aiding your immune system.

This is the last time we get to see this guy! *sad*

A colored sketch of a liver lobule with labeled parts.

Sinusoids of Immunity

The last part of the lobule to be discussed is the sinusoids.  Sinuses and sinusoids describe the space between (think about the sinuses in your your face – they are actually just holes and tubes through the bones of your face and skull that allow for empty space).

Sinusoids are lined with Kupffer cells (actually pronounced “Coop-fur”; I said it wrong on the broadcast – blame it on the accent).  Kupffer cells are a part of your immune system (remember that your immune cells flow through the lymph system that parallels your blood vessels).  Some of the cells involved in your immune system are called macrophages (big eater).  When they find something that’s not supposed to be there, they gobble it up and carry it off to be disposed of or dissolve it into it’s basic parts and makes it safe.

Summary

Kupffer cells are macrophages that are stationed in the sinusoids of your lobules of your liver.

So, if you’ve had an infection and you start to get better, where do all the dead bacteria go?  They end up floating around in your blood and the Kupffer cells will gobble them up.  Kuppfer cells will do this for bacteria, fungi, and micro-parasites that they encounter.  They also gobble up dead red blood cells and get them out of circulation.  Other types of cells in your body die periodically and they, too, get gobbled up by Kupffer cells and have their parts recycled.

Dying cells and bacteria can release toxins if you had to wait on them to break down and dissolve on your own.

The liver is very efficient at all the things it does. Without your liver, processes that help your body thrive would take too long for you to reap the benefits. 

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Cleaning Up Bacteria’s Mess [Show Notes]

Bacteria and Antibiotics

MIC stands for Minimum Inhibitory Concentration, and is the lowest amount of antibiotic required to stop the bacteria.

Antibiotics either kill the bacteria or slow it down enough that your own immune system can get rid of it.

Antibiotics are designed to keep a certain amount of medicine in your body over a certain number of days to ensure the infection is completely gone.

Do not take antibiotics that you have left over because you most likely do not have enough medicine for a full course of treatment.

Here’s a Metaphor

Think about a spot of dirt on the floor:

Dirt + a few drops of water = mud

Dirt + a whole pitcher of water = a watery mess

Dirt + a wet rag = clean floor

Relate it to Bacteria

Infection + too little antibiotic = resistance

Infection + too much antibiotic = side effects

Infection + the right dose of antibiotic = you get better

The Take Away

The gap between the lowest effective dose and the highest, non-toxic dose is called the Therapeutic Index.  This is the information that is used to determine the dose of many medications and how they should be taken. 

That is why you should always take antibiotics exactly as directed and until they are all gone.

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