MICROORGANISMS AND LEUKOCYTES IN PURULENT SINUSITIS - A SYMBIOTIC RELATIONSHIP IN METABOLISM

Since the exchange of gases, as well as metabolites, is greatly impede d in a paranasal sinus empyema, it is not unlikely that certain organi c substances be retained and accumulated in purulent secretion. In thi s study, secretions aspirated from experimentally infected maxillary s inuses of 26 rabbits were analysed biochemically. Quantitatively, by f ar the most important acid accumulated in secretions was lactic acid. Lactate induces metabolic acidosis and exerts an inhibitory effect on mammalian defense mechanisms. Lactate may also be used as an energy so urce by certain microorganisms. In spite of its leukocytic origin lact ic acid thus promotes the continuation of a bacterial infection. In ad dition, certain other organic acids of bacterial origin were found, wh ich, in different ways, contribute to the impediment of antimicrobial defense functions.