Pusis anexudate,typically white-yellow, yellow, or yellow-brown, formed at the site ofinflammationduring infections, regardless of cause.[1][2]An accumulation of pus in an enclosed tissue space is known as anabscess,whereas a visible collection of pus within or beneath theepidermisis known as apustule,pimpleor spot.
| Pus | |
|---|---|
 | |
| Eyewithconjunctivitisexuding pus | |
| Specialty | Infectious disease |
Description
editPus consists of a thin,protein-rich fluid (historically known asliquor puris[3][4]) and deadleukocytes(white blood cells) from the body'simmune response(mostlyneutrophils).[5]During infection,T helper cellsreleasecytokines,which trigger neutrophils to seek the site of infection bychemotaxis.There, the neutrophils releasegranules,which destroy the bacteria. The bacteria resist the immune response by releasingtoxinscalledleukocidins.[6]As the neutrophils die off from toxins and old age, they aredestroyedby macrophages, forming the viscous pus. Bacteria that cause pus are called pyogenic.[6][7]
Although pus is normally of a whitish-yellow hue, changes in the color can be observed under certain circumstances. Pus is sometimes green because of the presence ofmyeloperoxidase,an intensely green antibacterial protein produced by some types of white blood cells. Green, foul-smelling pus is found in certain infections ofPseudomonas aeruginosa.The greenish color is a result of the bacterial pigmentpyocyaninthat it produces.Amoebicabscesses of theliverproduce brownish pus, which is described as looking like "anchovy paste".Pus from anaerobic infections can more often have a foul odor.[8]
In almost all cases when there is a collection of pus in the body, a clinician will try to create an opening to drain it. This principle has been distilled into the famousLatinaphorism"Ubi pus, ibi evacua"(" Where there is pus, evacuate it ").
Some disease processes caused by pyogenic infections areimpetigo,[9]osteomyelitis,septic arthritisandnecrotizing fasciitis.
Pyogenic bacteria
editMany species of bacteria may be involved in the production of pus. The most commonly found include:[10]
- Staphylococcus aureus
- Staphylococcus epidermidis
- Streptococcus pyogenes
- Escherichia coli(Bacillus coli communis)
- Streptococcus pneumoniae(Fraenkel'spneumococcus)
- Klebsiella pneumoniae(Friedländer'sbacillus)
- Salmonella typhi(Bacillus typhosus)
- Pseudomonas aeruginosa
- Neisseria gonorrhoeae
- Actinomyces
- Burkholderia mallei(Glanders bacillus)
- Mycobacterium tuberculosis(tubercle bacillus)
Staphylococcus aureus bacteria is the most common cause ofboils.
Historical terminology
editIn the pre-asepsisera, surgeonFrederick Treves(1853–1923) wrote, "Practically all major woundssuppurated.Pus was the most common subject of converse [among surgeons], because it was the most prominent feature in the surgeon's work. It was classified according to degrees of vileness. " [11]: 347 But pus of the right kind was considered desirable.[12]: 80 "If a patient was lucky... a thick cream-colored odorless fluid would appear within five or six days "; such" laudable "pus was considered" a sure sign that the wound would heal " [11]: 344 because it meant "Nature has put up a bold fight against the invader".[13] "On the other hand, if the pus gradually became watery, blood tinged and foul smelling, it was designated 'sanious' [14] [or 'ill-conditioned' ] [15] and the wound condition was considered unfavorable ".[14] It later came to be understood that "laudable" pus generally implied an invasion of relatively benignstaphylococcus,while "ill-conditioned" pus usually meant the more dangerousstreptococcuswas present.[11]: 345 [14]: 247
See also
editReferences
edit- ^ "Pus".dictionary.reference.com.Retrieved2008-08-18.
- ^ "Pus – What Is Pus?".medicalnewstoday.com.Retrieved2016-08-19.
- ^British Medical Journal.British Medical Association. 1917. pp. 751–754.
- ^Society, Louisiana State Medical (1846).Journal.p. 251.
- ^Barer, M.R. (2012). "The natural history of infection".Medical Microbiology.Elsevier. pp. 168–173.doi:10.1016/b978-0-7020-4089-4.00029-9.ISBN978-0-7020-4089-4.
- ^abMadigan, Michael T. and Martin, John M. Brock Biology of Microorganisms 11th ed. Pearson Prentice Hall. US. 2006: 734
- ^"pyogenic"atDorland's Medical Dictionary
- ^Topazian RG, Goldberg MH, Hupp JR (2002).Oral and maxillofacial infections(4 ed.). Philadelphia: W.B. Saunders.ISBN978-0721692715.
- ^"Infections Caused by Common Pyogenic Bacteria",Dermatopathology,Berlin Heidelberg: Springer, 2006, pp. 83–85,doi:10.1007/3-540-30244-1_12,ISBN978-3-540-30245-2
- ^Thompson, Alexis; Miles, Alexander (1921)."Pyogenic Bacteria".Manual of Surgery(6th ed.). Oxford Medical Publications.OCLC335390813.
- ^abcNuland, Sherwin B. (2011).Doctors: The Biography of Medicine.Knopf Doubleday.ISBN978-0-307-80789-2.
- ^Van Hoosen, Bertha (Autumn 1947)."A Woman's Medical Training in the Eighties".Quarterly Review of the Michigan Alumnus: A Journal of University Perspectives.University of Michigan Libraries: 77–81. UOM:39015006945235.
- ^Scott, William (1922).An indexed system of veterinary treatment.Chicago: Eger. p. 603.
- ^abcSchneider, Albert (1920).Pharmaceutical bacteriology(2nd ed.). P. Blakiston. p.247.
- ^Williams, Charles J. B. (1848).Principles of Medicine: Comprising General Pathology and Therapeutics, and a Brief General View of Etiology, Nosology, Semeiology, Diagnosis, and Prognosis: With Additions and Notes by Meredith Clymer.Churchill. p. 306.
External links
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