Altered Physiology-Alterations in the immune System

Scenario 2: A 42-year-old man comes to clinic with chief complaint of pain, redness, and swelling of his right calf. He states that he had been working in his yard using a string trimmer when the trimmer slipped and cut his leg. He cleaned the wound with water from the garden hose and covered the wound with a large Band-Aid. Several days later, he developed fever to 100.6˚ F and chills and noticed that his leg was swollen and red. He comes to the emergency department for definitive care.
This paper must contain a title page, an introduction, a purpose statement, body, and conclusion – all with appropriate citations and references.
Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.

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Solution

Infections are a serious healthcare issue, especially those resistant to antibiotics, and they have an economic burden on the system and the patient. This week’s scenario entails a 42-year-old man presenting symptoms of redness, swelling, and pain on his right calf after a cut on his leg. He had cleaned the wound with garden hose water and covered it with a Band-Aid. After some days, he developed fever and chills, and his leg had swollen and was red. Thus, the discussion aims to determine the reasons for the patient to present the symptoms, identify the genes associated with the disease, and explain the immunosuppression process and its effects on body systems.

 

Reasons for the Patient Presenting the Symptoms

The patient in the scenario cut their leg with a string weed trimmer that could have harbored microorganisms, causing bacteria infection. The patient also used water from the garden hose and did not wash the wound properly with an antiseptic which could be contaminated, making it a source of infection and supporting the survival of microorganisms. Inflammation is a reaction to a tissue or cellular injury, whether the injured tissue is sterile or septic (McCance & Huether, 2019). The typical acute inflammation symptoms are heat, redness, pain, and swelling. Redness and heat result from vasodilation, an enhanced flow of blood through the injured site.

Swelling occurs as exudate, cells, protein, and solid materials gather. It generally causes pain due to the pressure from the buildup of exudate and soluble biochemical mediators like bradykinin and prostaglandins (McCance & Huether, 2019). Fever is a primary universal response, partly stimulated by cytokines, known as endogenous pyrogens. Pyrogen causes the release of prostaglandin that acts on the hypothalamus, raising the set point of the temperature such that the body temperature increases through heat vasoconstriction and generation. A fever can be a sign of harmful side effects resulting from the susceptibility of endotoxins related to gram-negative infections (McCance & Huether, 2019).

The healing of a wound is complex, extremely controlled, and could be jeopardized by endogenous pathophysiological (endogenous) or microorganisms (exogenous factors). Colonization of microbial of prolonged and serious wounds is unavoidable. Endogenous bacteria dominate in most circumstances, and they are pathogenic in a wound situation. A wound infection threat increases when the local conditions support the growth of bacteria instead of protecting the host.  Various bacteria types trigger cellulitis, a deeper layer of skin infection (CDC, 2020). The most common is group A strep or group A Streptococcus. Body openings like a cut, injury, surgical wound, or abrasion give room for bacteria to enter and develop infections in the body. When the patient covered the cut with a Band-Aid, he could have entrapped the bacteria in the wound’s surface, causing wound infection.

Genes Associated with the Disease Development

The cellulitis has no specific causal genes as long as there is a skin breakage, inappropriate treatment, and a host’s suppressed immune making them susceptible to infections. Bacterial cellulitis is recurrent, diffusely raising skin infections, where streptococci affect subcutaneous tissues more frequently (Bergbreiter et al., 2021). The genetic of the host influences their vulnerability to infections, but there exists limited evidence on genetic factors influencing cellulitis.

Immunosuppression process and its Effect on Body Systems

Immunosuppression is the suppression or a decrease in the ability of a body’s immune system to fight infections and other diseases. It can be deliberate where an individual is induced with drugs as preparation for organ transplantation like bone marrow to prevent donor tissue rejection (NIH, n.d.). Also, it results from particular diseases like lymphoma, AIDS, or anticancer drugs. It stems from killing immune effector cells or obstructing intercellular pathways necessary to identify antigens or other immune response elements. A person’s medical conditions like diabetes or immunosuppression affect wound healing negatively. Besides, diabetes is associated with high blood sugar and pressure; hence, blood circulation is obstructed often. The lower flow of blood impended the reaction to the healing of the wound by blocking essential cells like monocytes and platelets from moving into the wound.

From the discussion, it is clear the patient had cellulitis. This conclusion was arrived at after analyzing the symptoms presented. The disease was caused by bacteria entering the body through the cut, washing his wound with hose water and covering it with a Band-Aid. Over time, the bacteria caused an infection, leading to the presented symptoms. There are no genes related to cellulitis, but they could play a mediating role by influencing an individual’s immune, increasing their risk of developing an infection.

References

Bergbreiter, A., Jaeger, T., Karle, A., Bitzinger, D., Ettl, T., Spanier, G., … & Schreml, S. (2021). Recurrent necrotizing cellulitis, multi-organ autoimmune disease and humoral immunodeficiency due to a novel NFKB1 frameshift mutation. European Journal of Medical Genetics64(3), 104144.

Centers of Disease Control and Prevention. (2020). Necrotizing fasciitis. Centers for Disease Control and Prevention. https://www.cdc.gov/groupastrep/diseases-
public/Cellulitis.htm

McCance, K. L., & Huether, S. E. (2019). Pathophysiology – E-book: The biologic basis for disease in adults and children (8th ed.). Elsevier Health Sciences.

NIH (n.d.). Immunosuppression. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunosuppression