39 Clostridium

Question 1

What are the 4 primary diseases and the strain that Clostridium can cause?

Answer 1

• Tetanus (C. tetani)
• Botulism (C. botulinum, C. baratii, C. butyricum)
• Myonecrosis or gas gangarene ( C. perfringes, C. novi, C. speticum, C.histolyticum
• Diarrhea and colitis ( C. perfringens, C. difficile)

Question 2

Which toxin of C. perfringes type C causes enteritis necroticans, pig-bel.

Answer 2

Beta toxin

Question 3

Which type of strain of C. perfringes causes most human infections?

Answer 3

C. perfringes type A

Question 4

What are the clinical manifestations of C. perfringes?

Answer 4

• Soft-tissue infection: Cellulitis, suppurative myositis, myonecrosis
• Gastroenteritis: food poisoning, necrotizing enteritis.

Question 5

What is the physiology and structure of C. tetani?

Answer 5

• Motile, spore-forming rods, G (+) that give it the appearance of a drumstick. Difficult to grow and extremely oxygen sensitive.

Question 6

What are the various clinical manifestations of C. tetani infection?

Answer 6

• Generalized tetanus (risus sardonicus, opisthotonos)
• Localized tetanus
• Cephalic tetanus
• Neotal tetanus

Question 7

What is the treatment for C. tetani infection?

Answer 7

• Debridement of the primary wound site, use of metronidazole, passive immunization w/ human tetanus immunoglobulim, and vaccination with tetanus toxoid.

Question 8

Describe the physiology and structure of C. botulinum.

Answer 8

• Large, fastidious spore-forming anerobic rods.

Question 9

Describe what the C. botulinum toxin does and the end result.

Answer 9

• It inactivates the proteins that regulate release of acetylcholine, blocking neurotransmission at the peripheral cholinergic synapse. End result is flaccid paralysis.

Question 10

What are the clinical manifestations of foodbourne botulism?

Answer 10

• Weak and dizzy 1-3 days after consumption. Blurred vision w/ fixed, dilated pupils, dry mouth, constipation and abdominal pain. Fever is absent. Bilateral descending weakness of the peripheral muscles develops in patients with flaccid paralysis and death to respiratory paralysis.

Question 11

What is the treatment for C. botulinum?

Answer 11

• 1) adequate ventilation support
• 2) metronidazole or penicillin therapy to eliminate the organism from GI tract
• 3) use of trivalent botulinum antitoxin. Versus toxins A, B, and E circulating in blood.

Question 12

What are the two toxins that C. difficile produce?

Answer 12

• Enterotoxin (toxin A) and cytotoxin (toxin B)

Question 13

What is the treatment for C. difficile diarrhea and colitis?

Answer 13

• Metronidazole or vancomycin

Question 14

Describe the physiology and structure of C. perfringes.

Answer 14

• Associated with simple colonization to life-threatning disease. It is large, rectangular, G(+) rod with spores rarely observed. They are nonmotile.

Question 15

Describe the Alpha toxin of C. perfringes.

Answer 15

• The most important toxin, it’s a lecithinase (phospholipase C) that lyses erythrocytes, platelets, leukocytes, and endothelial cells, resulting in massive hemolysis, tissue destruction, hepatic toxicity, and myocardial dysfunction.

Question 16

What does tetanospamin specifically target and its result?

Answer 16

• Inactivates proteins that regulate release of the inhibitory neurotransmitter glycine and GABA. Leads to unregulated excitatory synaptic activity in the motor neurons resulting in spastic paralysis.

Question 17

What is the treatment for C. perfringes?

Answer 17

• Surgical debridement and high-dose penicillin therapy.

Question 18

What are the two toxins that C. tetani produce?

Answer 18

• Tetanolysin: oxygen-labile hemolysin

- Tetanospasmin: heat-labile neurotoxin (A-B toxin)