Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Defenses Against Infection

By

Larry M. Bush

, MD, FACP, Charles E. Schmidt College of Medicine, Florida Atlantic University

Last full review/revision Jul 2020| Content last modified Jul 2020
Click here for the Professional Version

Natural barriers include the skin, mucous membranes, tears, earwax, mucus, and stomach acid. Also, the normal flow of urine washes out microorganisms that enter the urinary tract.

Natural Barriers

Mucous membranes, such as the lining of the mouth, nose, and eyelids, are also effective barriers. Typically, mucous membranes are coated with secretions that fight microorganisms. For example, the mucous membranes of the eyes are bathed in tears, which contain an enzyme called lysozyme that attacks bacteria and helps protect the eyes from infection.

The airways Overview of the Respiratory System To sustain life, the body must produce sufficient energy. Energy is produced by burning molecules in food, which is done by the process of oxidation (whereby food molecules are combined with... read more filter out particles that are present in the air that is inhaled. The walls of the passages in the nose and airways are coated with mucus. Microorganisms in the air become stuck to the mucus, which is coughed up or blown out of the nose. Mucus removal is aided by the coordinated beating of tiny hairlike projections (cilia) that line the airways. The cilia sweep the mucus up the airways, away from the lungs.

The urinary tract Overview of the Urinary Tract Normally, a person has two kidneys. The rest of the urinary tract consists of the following: Two ureters (the tubes connecting each kidney to the bladder) The bladder (an expandable muscular... read more also has several effective barriers. The bladder is protected by the urethra Urethra The urethra is a tube that drains urine from the bladder out of the body. In men, the urethra is about 8 inches (20 centimeters) long, ending at the tip of the penis. In women, the urethra is... read more Urethra , the tube that drains urine from the body. In males, the urethra is long enough that bacteria are seldom able to pass through it to reach the bladder, unless the bacteria are unintentionally placed there by catheters or surgical instruments. In females, the urethra is shorter, occasionally allowing external bacteria to pass into the bladder. In both sexes, when the bladder empties, it flushes out any bacteria that reach it.

The Blood

The body also defends against infection by increasing the number of certain types of white blood cells (neutrophils Neutrophils One of the body's lines of defense (immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more and monocytes Monocytes and Macrophages One of the body's lines of defense (immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more ), which engulf and destroy invading microorganisms. The increase can occur within several hours, largely because white blood cells are released from the bone marrow, where they are made. The number of neutrophils increases first. If an infection persists, the number of monocytes increases. The blood carries white blood cells to sites of infection.

The number of eosinophils Eosinophils One of the body's lines of defense (immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more , another type of white blood cell, increases in allergic reactions and many parasitic infections, but usually not in bacterial infections.

However, certain infections, such as typhoid fever Typhoid Fever Typhoid fever is caused by certain types of the gram-negative bacteria Salmonella. It typically causes a high fever and abdominal pain. Typhoid fever can be spread by consuming food or water... read more Typhoid Fever , viral infections, and bacterial infections that overwhelm the immune system, can lead to a decrease in the white blood cell count.

Inflammation

Any injury, including an invasion by microorganisms, causes inflammation in the affected area. Inflammation, a complex reaction, results from many different conditions. The damaged tissue releases substances that cause inflammation and that direct the immune system to do the following:

  • Wall off the area

  • Attack and kill any invaders

  • Dispose of dead and damaged tissue

  • Begin the process of repair

However, inflammation may not be able to overcome large numbers of microorganisms.

During inflammation, the blood supply increases, helping carry immune cells to the affected area. Because of the increased blood flow, an infected area near the surface of the body becomes red and warm. The walls of blood vessels become more porous, allowing fluid and white blood cells to pass into the affected tissue. The increase in fluid causes the inflamed tissue to swell. The white blood cells attack the invading microorganisms and release substances that continue the process of inflammation.

Other substances trigger clotting in the tiny vessels (capillaries) in the inflamed area, which delays the spread of the infecting microorganisms and their toxins.

Many of the substances produced during inflammation stimulate the nerves, causing pain. Reactions to the substances released during inflammation include the chills, fever, and muscle aches that commonly accompany infection.

Immune Response

When an infection develops, the immune system also responds by producing several substances and agents that are designed to attack the specific invading microorganisms (see Acquired Immunity Acquired Immunity One of the body's lines of defense (immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more Acquired Immunity ). Examples are

Antibodies attach to and immobilize microorganisms. They kill them outright or help neutrophils target and kill them.

How well the immune system defends the body against each microorganism depends partly on a person's genetic make-up.

Fever

Body temperature increases as a protective response to infection and injury. An elevated body temperature (fever Fever in Adults Fever is an elevated body temperature. Temperature is considered elevated when it is higher than 100.4° F (38° C) as measured by an oral thermometer or higher than 100.8° F (38.2° C) as measured... read more ) enhances the body’s defense mechanisms, although it can cause discomfort.

A part of the brain called the hypothalamus controls body temperature. Fever results from an actual resetting of the hypothalamus's thermostat. The body raises its temperature to a higher level by moving (shunting) blood from the skin surface to the interior of the body, thus reducing heat loss. Shivering (chills) may occur to increase heat production through muscle contraction. The body's efforts to conserve and produce heat continue until blood reaches the hypothalamus at the new, higher temperature. The new, higher temperature is then maintained. Later, when the thermostat is reset to its normal level, the body eliminates excess heat through sweating and shunting of blood to the skin.

Certain people (such as alcoholics, the very old, and the very young) are less able to generate a fever. These people may experience a drop in temperature in response to severe infection.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read

Test your knowledge

Respiratory Syncytial Virus (RSV) Infection and Human Metapneumovirus Infection
Respiratory syncytial virus (RSV) infection and human metapneumovirus infection (hMVP) cause upper and sometimes lower respiratory tract infections. Symptoms of both viruses are similar although the viruses are different. In which of the following ages groups is RSV a very common cause of respiratory tract infections?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
TOP