Understanding gene-related processes that regulate the manifestation of a disease in an individual’s organism is crucial for determining the diagnosis and prescribing the correct treatment. The symptoms may deviate from defined standards due to the presence or absence of specific genes that regulate the organs affected by the disease. Thus, it is important for a nurse to understand the intricate processes behind the organism’s reactions to the infectious agent to ensure the best patient outcome.
The patient is a 42-years old man suffering from overall high fever and swelling, redness, and pain in his right calf. The symptoms began to develop after he accidentally injured himself with a trimmer during his garden tending. The patient did not disinfect the injury right away, stating that he only cleaned it up with water from the hose and covered it with a Band-Aid. Several days later, began suffering from a 100.6˚ F fever and chills as well as from the aforementioned symptoms in his leg.
The symptoms point toward the patient having cellulitis – a bacterial infection caused by staphylococci and streptococci that might occur when the skin is broken. This diagnosis is supported by the fact that the area of injury on the patient’s right calf is red and swollen and is also painful to touch. Swelling, redness, and pain are the signature symptoms of the local inflammatory process – the cells and tissues are reacting to the bacteria in the main site of infection. According to Sullivan (2018), “timing and evolution of the skin findings may differentiate cellulitis from some of the common mimics with the more chronic clinical course” (p. 160). Moreover, the inflammation causes a high fever in the patient, which is followed by chills. The fact that the patient did not disinfect the wound inflicted by gardening equipment is unsterile evidence that it is indeed a case of infection.
Genes Associated with the Development of Cellulitis
The most relevant here are the genes responsible for the synthesis of cytokines as well as other effector molecules involved in inflammatory processes. For example, Petrova et al. (2019) report that “the naive B cell repertoire exhibited multiple perturbations after measles infection, including a profound skew toward clones with immature features in ~10% of the cohort” (p. 1). Moreover, mutations in specific genes that encode key pathogen detection receptors might affect an organism’s susceptibility to certain infectious agents.
Immunosuppression and Its Effects on the Body
Immunosuppression refers to the process of the inhibition of the immune system due to physiological, pathological, or artificial causes. Along with the stimulation of protective mechanisms – the complement system, antibody formation, macrophages and neutrophils, cellular (T-dependent) immunity – infectious agents have diverse damaging effects on the immune system. Immunosuppression in infections can be general – like suppression of T- or/and B-cell immunity – or specific – most often, in long-term persistent infections. It is assumed that in a number of situations, immunosuppression may be associated with polyclonal activation of B cells and/or activation of cells with suppressor activity. The causative agents of almost all infections stimulate immunosuppressive mechanisms in the body by inhibiting the activity of genes responsible for encoding immune response proteins. This causes secondary immunodeficiency that can be a cause of further infection. Schröder et al. (2017) add that “the prevalence of complications and of healthcare resource utilization is highest in severely immunocompromised patients” (p. 207). The deficiency of the immune system is the most threatening consequence of infectious diseases.
Infectious diseases often occur due to the lack of hygienic and disinfection measures, especially in cases of minor skin injury. The patient’s neglect of their injury caused him to develop cellulitis, which may have severe consequences. In general, immune responses are based on the genetic processes related to the specific genes that encode immunity system proteins such as cytokines and cells like T- and B-lymphocytes. The presence of untreated or acute infection in the organism may cause immunosuppression – a process that can lead to secondary immunodeficiency and pose a serious threat to the patient.
Petrova, V. N., Sawatsky, B., Han, A. X., Laksono, B. M., Walz, L., Parker, E., Pieper, K., Anderson, C. A., de Vries, R. D., Lanzavecchia, A., Kellam, P., von Messling, V., de Swart, R. L., & Russell, C. A. (2019). Incomplete genetic reconstitution of B cell pools contributes to prolonged immunosuppression after measles. Science Immunology, 4(41). Web.
Schröder, C., Enders, D., Schink, T., & Riedel, O. (2017). The incidence of herpes zoster amongst adults varies by the severity of immunosuppression. Journal of Infection, 75(3), 207–215. Web.
Sullivan, T., & de Barra, E. (2018). Diagnosis and management of cellulitis. Clinical Medicine, 18(2), 160–163. Web.