1. symmetric descending flaccid paralysis 2. absence of fever 3. intact sensorium

FINALS L3 Flashcards by Mark James Mateo

Clostridium Morphology

endospore forming large gram positive bacillus

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we acquired dxs from clostridium through what?

through the inoculation of the bacilli spores

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Clostridium welchii

Clostridium perfringens

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Bacillus aerogenes capsulatus

Clostridium perfringens

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Gas gangrene bacillus

Clostridium perfringens

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Do not produce spores in ordinary media

Clostridium perfringens

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presence of terminal spores which gives its
TACK HEAD OR DRUMSTICK OR LOLLIPOP OR TENNIS RACKET APPEARANCE

Clostridium tetani

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(Clostridium)
All are motile except ____

Clostridium perfringens

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Primary isolation used for Clostridium

Nonselective
Selective
Liquid media

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C. perfringens produces ____ in nonselective supplemented anaerobic blood agar

a classic DOUBLE ZONE OF HEMOLYSIS (beta hemolysis surrounded by alpha hemolysis)

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(Clostridium)
Nonselective, differential medium

Egg yolk agar

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(Clostridium)
allows differentiation based on

Lecithinase (white precipitate)
Lipase (sheen around surface of colonies)
Protease production (clearing)

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canned good bacillus

Clostridium Botulinum

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agent of canned good bacillus botulism

Clostridium botulinum

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(Clostridium Botulinum)
Types of toxins

A - most common/ potent
B
E
F
G

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(Clostridium botulinum)
Toxins block the release of ____

acetylcholine

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causes flaccid paralysis

Clostridium botulinum

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Clostridium botulinum
MOT

INGESTION of food containing the microorganism and its spores

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(c. botulinum)
symptoms

visual disturbances
inability to swallow
speech difficulties
bulbar paralysis (ptosis)

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may cause Sudden Infant Death Syndrome

Clostridium botulinum

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organism germinates in the wound abcess

wound botulism

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Triad of botulism

symmetric descending flaccid paralysis
absence of fever
intact sensorium

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Clostridium botulinum
DIAGNOSIS
ADULT:
INFANT:

demonstration of toxin by passive hemagglutinaton or radioimmunoassay

ADULT: serum and left-over food
INFANT: stool

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tack head bacillus

Clostridium tetani

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Clostridium tetani VIRULENCE FACTOR

Spores - germinate anaerobically, terminally located Glysine and GABA (gamma-aminobutyric acid) - inhibits muscle contraction

Clostridium tetani causes lock jaw. What's the characteristic?

risus sardonicus or distorted grin

other name of lock jaw

trismus

arching of the back

ophisthotonus

Clostridium tetani incubation period

4-5 days up to weeks

Exotoxins that Clostridium tetani produces

Hemolysin Tetanospasmin

can travel to the CNS humorally through blood and lymph, or neurally through tissue spaces of the peripheral nerves. Leads to lock jaw and opisthotonus

Tetanospasmin

anaerobic, large gram-positive, spore-forming rods

CLOSTRIDIUM PERFRINGENS

Does not form spore in ordinary media

Clostridium perfringens

Produces invasive infection including myonecrosis and gas gangrene

C. perfringens

C. perfringens produces an enterotoxin which is a common cause of

Food poisoning

C. Perfringens in BAP

Double zone of hemolysis around colonies

(C. perfringens) T or F growth on egg-yolk agar

(C. perfringens) nonmotile but with rapidly spreading growth on ____ media

culture

C. perfringens VIRULENCE FACTOR

●Lecithinase - white precipitate in egg yolk agar ● Alpha toxin ● Delta/Theta toxin ○Theta toxin- complete hemolysis ○ Alpha toxin- incomplete hemolysis

Localized edema and erythema with gas formation in soft tissue, and generally not painful

CELLULITIS

Accumulation of pus in muscle planes without muscle necrosis or systemic symptoms

SUPPURATIVE MYOSITIS

Infection spreads 1-3 days to produce crepitation in the subcutaneous tissue and muscle ●Foul-smelling discharge, rapidly progressing necrosis and fever ● Toxemia, shock and ultimately death.

MYONECROSIS

● This usually follows the ingestion of large numbers of clostridia that have grown in warmed meat dishes ● Self-limiting but produces Diarrhea without vomiting and fever ● Lasts only 1-2 days

FOOD POISONING

Acute necrotizing destruction of the jejunum with abdominal pain, vomiting, bloody diarrhea and peritonitis

NECROTIZING ENTERITIS

C. perfringens SPECIMEN

material from wounds, pus and tissue

C perfringens Special stain (appearance niya ata to)

gram-positive rod with spores

C perfringens Growth on BAP:

double zone of hemolysis

C. perfringens Reverse CAMP test:

C. perfringens Lecithinase

C. perfringens SPECIAL STAIN

Schaeffer-Fulton

Anaerobic, gram-positive, spore-forming rods

CLOSTRIDIUM DIFFICILE

C. difficile Exotoxin in stool detected by ____ on cultured cells or ELISA

cytopathic effect

Toxins of C. difficile

Toxin A Toxin B

potent enterotoxin, cytotoxic activity, binds to the brush borders of the GUT at the receptor site

Toxin A

potent cytotoxin

Toxin B

C. perfringens MOT

Fecal- oral route

C. difficile clin. manifestations

Pseudomembranous colitis

C. difficile in culture medium

white colonies with distinctive horse-stable odor

C. difficile in CCFA

yellow, groundglass appearing colonies

Other Clostridium

Clostridium tertium : wound infections Clostridium septicum : nontraumatic myonecrosis in immunocompromised patients Clostridium sordelii : toxic shock syndrome associated with septic abortion

Small, gram positive, aerobic to microaerophilic coccobacilli that are non acid fast and non spore formers ● Facultative anaerobe

LISTERIA MONOCYTOGENES

LISTERIA MONOCYTOGENES motile on broth

Tumbling motility

LISTERIA MONOCYTOGENES appearance on semi-solid media

umbrella-like☂️ or inverted Christmas tree

Can Listeria Monocytogenes grow at 4°C and in high salt concentration (cold enrichment)? Yes or No

Yes

Listeria monocytogenes MOT

food ingestion contaminated with the organism; transplacental (mother-child)

Listeria 2 known specie: human: animals:

L. monocytogenes L. ivanovii

LISTERIA Grow best at Slow growth at Poor growth at

25-35°C 4°C 42°C

LISTERIA Virulence Factors

● Internalin (A and B) : interacts with E-cadherin on the surface of cells ● Listeriolysin O (LLO) : oxygen labile; escape from phagosomes ● Actin rockets (actin polymers) : propels the bacteria through the membrane of one human cell and into another

Virulence test in L. monocytogenes

Anton’s Test or Ocular test of Anton

(L. monocytogenes) Clin. Manifestation

NEONATAL DISEASE DXS IN HEALTHY ADULTS LISTERIOSIS

Early onset of neonatal dx

Granulomatosis infantiseptum

Late onset of neonatal dx

Acquired in utero dissemination meningitis