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MICROBIOLOGY > Botulism and Tetanus > Flashcards

Botulism and Tetanus Flashcards

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1
Q

Answer the objectives

A

REFER TO HANDOUT

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2
Q

Define an anaerobic bacteria.

A

Require reduced oxygen tension for growth, failing to grow on the surface of solid media in 10% CO2 in air.

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3
Q

Define a microaerophillic bacteria?

A

Can grow in 10%CO2 or under anaerobic or aerobic conditions

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4
Q

Define facultative bacteria

A

Can grow in the presence or absence of air.

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5
Q

Give 3 examples of bacterial species that are anaerobes and the infection they cause?

A

1.Bacteriodes-Intra abdominal,Pelvic
2.Clostridium -Tetanus,Food poisoning and Gas gangrene 3.Peptostreptococcus-Oral,Genital Tract

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6
Q

Example of a bacteria species that is a micraerophillic bacteria and the infection it causes.

A

Campylobacter jejuni-Food poisoning

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7
Q

Example of a facultative anaerobe and the infection it causes.

A

Salmonella typhi-Typhoid fever

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8
Q

What is Botulism?

A

A severe sometimes fatal food poisoning caused by ingestion of toxin produced by Clostridium botulinum

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9
Q

What causes Botulism in infants besides clostridium Botulinum

A

It can be caused by other specific types of clostridium obtained from the soil or inhaled spores, causing bacteria in infant’s intestine.

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10
Q

What are the three types of botulism?

A

1.Food-borne
2.Wound
3.Infant

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11
Q

What are he characteristics of botulism?

A

Nausea,vomiting,disturbed vision and paralysis

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12
Q

What is Botulinum Toxin?

A

It is a neurotoxin that blocks the ability of motor nerves to release acetylcholine.

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13
Q

How many types of Botulinum are there?Name them?

A

8
A,B,C1,C2,D,E,F,G

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14
Q

Which type of toxin is harmful to humans and to animals?

A

Humans-A,B,E,F,
Animals-C and D

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15
Q

Where does paralysis start and how does it spread?

A

From the muscles of the face towards the limbs.

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16
Q

What is the mechanism of action of botulinum toxin?

A

It binds the to axons near the neuromuscular junction and inhibits the release acetylcholine from the motor nerve cells leading to flaccid paralysis.

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17
Q

What is the function of acetylcholine?

A

It is used to transfer signals from nerve cells to muscle cells and effective for muscle contraction.

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18
Q

Besides C.Botulinum what other clostridia causes Botulism?

A

C.argentinense,C.butyricum,
C. baratii

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19
Q

What is the incubation period in Food one botulism ?

A

18 to 36hrs of eating the contaminated food with extremes of 4hr to 8 days

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20
Q

Symptoms of food borne botulism?

A

1.Blurred vision/double vision and difficulty swallowing and speaking
2.GI problems:Constipation,nausea and vomiting
3.In later stages the patient experiences weakness or paralysis, starting with the head muscles and progressing down the body.
4.Difficulty breathing
5.Without medical care, respiratory failure and death are very likely.

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21
Q

What age group of infants is affected by C.Botulinum?

A

those under 12months

22
Q

How does C.botulinum colonise the intestines of infants?

A

Ingestion of spores in honey or by swallowing spore-containing dust/dirt.

Spore germinate in the large intestines and once colonised the toxin is produced and absorbed from the intestinal tract into the infant’s body.

23
Q

Symptoms of infant botulism?

A

1.Constipation,lethargy and poor feeding
2.Difficult in sucking and swallowing
3.Breast engorgement is experienced by the nursing mother.
4.flaccid paralysis results in the baby appearing floppy.
5.Breathing is impaired thus respiratory failure is a real danger.
6.Overall weakness and cannot control head movements.

24
Q

Symptoms of wound botulism?

A

Same as those of food borne Botulism without the gastrointestinal symptoms.

25
Q

What leads/causes wound botulism ?

A

Cases linked to trauma e.g a severe crush injuries to the extremities,surgery and illegal drug use.Which results in colonisation of the wound by C.Botulinum and production of botulinum toxin.

26
Q

Incubation period in wound botulism?

A

4 to 18 days after injury has occurred.

27
Q

Describe the Diagnosis of Botulism?

A

REFER TO HANDOUT.

28
Q

What are the neurological symptoms presented by a patient with botulism?

A

1.Descending Paralysis
-Peripheral flaccid muscle paralysis that descends caudally(typically begins in frequently used muscles)
-Pupils:Mydriasis and diplopia,accomodation paralysis
-Pharynx:dysphagia and dysarthria
2.Autonomic nervous system:Xerostomia
3.infants-ptosis,floppy movements, general weakness and poor feeding

29
Q

GI symptoms presented by a patient suffering from botulism?

A

Vomiting,nausea,GI discomfort,and later followed by constipation

30
Q

In which type of botulism are GI symptoms not seen?

A

Wound Botulism

31
Q

What percentage of patients suffering from food borne botulism experience GI symptoms?

A

30%

32
Q

How is the lab diagnosis of botulism done?

A

Rapid identification of the toxin in samples of serum,vomit,gastric acid,stooland suspicious food.

33
Q

Describe the treatment of Botulism?

A

It includes :
1.adminstration of antitoxins
2.Respiratory support-A tracheostomy may be necessary
3.Gastric lavage

34
Q

Where is the antitoxin derived?

A

Horse serum

35
Q

Mechanism of action of the antitoxin?

A

It binds to the toxin that is not attached to the nerve endings

36
Q

Which antitoxin is preferred treatment for kids?

A

Human botulism immunoglobulin

37
Q

How long does antitoxin for toxins A and B provide protection for?

A

4months.

38
Q

Which organism causes tetanus ? And where is it found?

A

Clostridium Tetani
Soil and intestinal tracts

39
Q

How is C.Tetani introduced into tissues?

A

Via wounds,particularly deep puncture wounds that provide a suitable anaerobic environment.

40
Q

In what conditions/kind of tissue are the C tetani spores unable to grow?

A

In normal tissue or in wounds whose tissue remains at the oxidation-reduction potential of circulating blood.

41
Q

How is tetanus toxin produced by ?

A

The bacteria in the necrotic tissue becomes localised and multiplies.As the bacteria cells undergo autolysis, the potent neurotoxin is released.

42
Q

Mechanism of action of Tetanus toxin.

A

it is a zinc-binding protease that cleaves synaptobrevin.,inhibiting the release of inhibitory neurotransmitters glycine and GABA from presynaptic nerve endings causing spasmodic, tonic contractions.

43
Q

Describe the difference between ascending and descending tetanus?

A

Ascending:The toxin is absorbed by the the motor nerves in the area and passes up the nerve tract to the spinal cord

Descending:occurs when there is too much toxin released at the site of infection than the motor nerves can take up and asa result the excess is carried off by the lymph to the bloodstream to the CNS where it causes descending tetanus.

44
Q

What effect does the toxin have on the muscles?

A

It causes spasmodic,tonic contractions that may be severe enough to cause muscle tears and bone fractures.

45
Q

What do muscles affecting the larynx,diaphragm and intercostal muscles lead to?

A

Respiratory failure.

46
Q

How is the autonomic nervous system affected by the toxin.

A

cardiac arrhythmias,tachycardia and hypertension

47
Q

In what conditions does C. Tetani survive in?

A

Deepcontaminated wounds or in wounds with foreign objects.

48
Q

What part of the organism is the toxin found on and what two components does it consist of?

A

Plasmid
Tetanospasmin and tetanolysin

49
Q

When tetanus toxin is produced, what state is it in?And how does it change?

A

1.Inactive
2.Activity is induced by proteolytic enzymes.

50
Q

Incubation period of tetanus?

A

one to several weeks but usually averages 10-14 days.

51
Q

Describe the clinical presentation of patients with tetanus.

A

1.localized stiffness-invovling masseter muscles, muscles of the neck, lower limbs and region of infected wound.
2.generalized stiffness which becomes pronounced a day later,tonic spasms and hyperesthesia becomes evident.
3.Reflexes increase intensity and the patient becomes more excited into more violent, general spasms by sudden movement or noise
4.sweating is. common
5.spasms of the neck and back muscles cause extension of head and neck
6.Spasms of head muscles cause difficulty in apprehension and mastication of food hence the commonanme lockjaw.

52
Q

Describe the treatment of tetanus?

A

1.Wounds that result in a break in the skin should be cleaned with soap and running water.
2.Antibiotics to kill bacteria
3.Antitoxin to neutralise the toxin
4.Supportive measures
5.Sedatives(diazepams) to control muscle spasms
6.IV rehydration-as muscles spasm constantly,metabolic demands on the body increase.
7.Tetanus vaccine given in infancy and booster vaccine at risk population

MICROBIOLOGY (3 decks)

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