Gas Gangrene, Tetanus and Actinomycoses

Question 1

CLOSTRIDIUM SPECIES

Over a hundred species
Gram-_________
(sporing or Non-sporing?)
(Cocci or Bacilli?)

Catalase ________
_________ in nature

Most are (motile or immobile?)

Answer 1

-positive
sporing
bacilli

Positive
Ubiquitous
Motile

Question 2

CLOSTRIDIUM SPECIES

Spore distends the ______

Most are motile by _________ flagella

(Invasive or Not invasive?)

Diseases are due to ___________________

Answer 2

sides

peritrichous flagella

Not invasive

elaboration of highly effective toxins.

Question 3

Gas gangrene is a (mildly or highly?) lethal infection of ________ tissue - _______necrosis

Infection caused most frequently by the toxin of the bacteria _____________________, spores of which are present in _______

Answer 3

highly ; deep soft

Myonecrosis

Clostridium perfringens

soil

Question 4

Aetiological agent of Gas Gangrene

C.perfringens - ____% to ___%,

Most common, (motile or non motile?) , relatively _________.

Produces ____ toxins.
____types

Type ____ is most common
All produce ________- toxin and most produce _______ toxin

also causes Enteritis __________ (______) and __________

Answer 4

80% to 90%,

non motile ; aerotolerant.

12 toxins ; 5types
Type A

Alpha ; theta

Enteritis necroticans

pig bel

Food poisoning

Question 5

Aetiological agent of Gas Gangrene

Other causes of Gas gangrene. These organisms are in the ______ and ________ especially if contaminated with _____ material

Clostridium ______ (40%),
C. ________ (20%)
C.__________(10%)
Clostridium ________ (10%),
Clostridium ______ (5%),
C. ________. (obstetric cases)

Answer 5

soil ; organic waste

fecal material

novyi
septicum
histolyticum
bifermentans
fallax
sordellii.

Question 6

C. septicum (20%) - is associated with _____ complication of Ca ______

Answer 6

GIT

Colon, C.

Question 7

Activity of Toxins

Alpha toxin: __________ (or ___________), -also ________ and _______.

Beta toxin: _______ of tissue

Delta toxin: _________

Epsilon toxin: Acts to _______________________; _________.

Answer 7

Lecithinase (or phospholipase)

hemolytic and cardiotoxic.

Necrosis of tissue

Hemolysin

increase cell membrane permeability; permease.

Question 8

Alpha toxin: Lecithinase (or phospholipase) that breaks down ______________ resulting in _________ and ____________

Answer 8

cell membrane

cell death and tissue necrosis.

Question 9

Activity of Toxins

Iota toxin: ________ of ________

Kappa toxin: ________, ________, necrosis of tissue.

Lambda toxin: ________

Mu toxin: ________

Nu toxin: ________, ________ and necrosis of tissue

Phi toxin: ________, ________

Answer 9

Necrosis of tissue

Collagenase, gelatinase, necrosis of tissue.

Protease

Hyaluronidase

Deoxyribonuclease, hemolytic

Hemolysin, cytolysin

Question 10

Pathogenesis
________ of spores in tissue leads to ________

Bacterial ________ and ______ production

Alpha toxin breaks down ________ triggering ________, ________, and ________ release.

Also release of ________ from ________

Answer 10

Germination ; toxin release

multiplication ; toxin

cell membranes ; platelet aggregation

thrombosis; histamine release.

gas ; muscle death

Question 11

Pathogenesis

Theta toxins cause
•direct ________
•_________ of leukocytes
•Results in ________ host inflammatory response to the infection

Also present are
Collagenase - breaks down __________ allowing the rapid spread of the organism across tissue planes. - one of the main reasons infection crosses over connective tissue plains and into deeper muscle tissues.

________ase
________ and ________.
The infection can spread quickly, and within a matter of several hours lead to shock, sepsis, and death.

Answer 11

vascular injury

leukocytes

blunted

Collagenase ; Hyaluronidase

Hemagglutinins and hemolysins.

Question 12

Clinical presentation of ,.perfringens

Incubation period a _______ to _______

Toxaemia; Fever
_______ cardia ; Pallor

Wound under _______ , with _______ discharge

Skin _______, _______

Jaundice, _______uria

Answer 12

a few hrs ; 2 days

Tachy ; tension

foul smelling ; darkening

Crepitus; oliguria

Question 13

Lab diagnosis can be done to differentiate gas gangrene from _______________________

Answer 13

anaerobic streptococcal myositis

Question 14

Investigations of gas gangrene

________
Biochemistry, _________ function tests , ________ function tests
CT
Gram stain
Microscopy and culture
Nagler reaction

Answer 14

Xray
Liver; kidney

Question 15

SPECIMENS for laboratory diagnosis

1 Films from

-the muscles at the _____________
-the tissue in the _________
- exudate in the _________________

Answer 15

edge of the affected area.

necrotic area.

deeper parts of the wound.

Question 16

SPECIMENS for laboratory diagnosis

Exudates from:
- the parts where the ___________
- the _______ of the wound .
They are collected with a ———— or a ______.

Answer 16

infection appears most active.

depths

capillary pipette ; swab

Question 17

SPECIMENS for laboratory diagnosis.

LIST 3

Answer 17

FILMS

EXUDATES

Necrotic tissue and muscle fragments

Question 18

Microscopy and Culture of C.perfringens

_______ spore in culture,

_________ shaped
gram-_______ rods in direct film

(Motile or Not motile?),

________ haemolysis,

Positive _____ reaction,___________ ______ reaction.

Treatment: _______,_______

Answer 18

No spore; Box car

positive; Double-zone

Naglar reaction; Stormy clot reaction.

Surgery ; Penicillin