GI 2 Flashcards
types of toxin released from bacillus cereus
emetic toxin and enterotoxin
ST (heat stable) neurotoxin
habitat for bacillus cereus
air, soil, water, and dust
incriminated food for bacillus cereus
rice and pulses (beans and lentils)
incubation period and duration period of b. cereus
incubation is 2-3 hours
and it lasts for 6-24 hrs
how do you differentiate staph aureus and b. cereus
the incriminating food, the toxins released, habitat found in
how does one isolate and identify b. cereus
non selective medium: blood agar
sometimes + polymyxin suppresses gram neg bacteria
toxins released by clostridium botulinum
exotoxin and neurotoxin (A, B, C1, C2, D, E, F, G)
what is c. botulinum susceptible to
penicillin
habitat that c. botulinum is found in
soil (fertilized animal excreta), lower GI tract humans and animals
incriminated food of c. botulinum
home canning, meats, vegetables, fish, fruits, and condiments
major concern food processor and consumers
most potent c. botulinum toxin
toxin A –> kills humans
what happens with muscles with c. botulinum toxin
muscle will not contract and will remain in its relaxed state – flaccid paralysis
c. botulinum toxins found in human, ones found in US, ones found in Europe
humans - A, B, C and rarely F
US - A then B and E
Europe - B (rarely A)
symptoms of c. botulinum
nausea, vomiting, abdominal pain, diarrhea
GI disturbances in some patients
serious disease can be fatal within 24 hours
how do you diagnose c. botulinum
REPORTABLE DISEASE
presumptive diagnosis: presence of rapidly descending paralysis and history of home canned and fermented food
confirmative diagnosis: toxin in serum/feces or incriminating food (mouse toxin neutralization test)
differential diagnosis for c. botulinum
guillian barre - ascending paralysis with elevated CSF protein
myasthenia gravis - descending paralysis occurring with increased activity and positive response to edrophonium
other microbial food poisoning and gastroenteritis: no cranial nerve involvement
chemical and non microbial food poisoning: symptoms occur within minutes
what is infant botulism
not food poisoning
ingestion of spores of c. botulinum –> spore germination in GI tract –> vegetative cells –> replicate and release toxin
what are symptoms of infant botulism
illness and constipation –> lethargy, sleep more than normal, suck and gag reflex diminish, dysphagia (with drooling) –> head control lost and infant becomes flaccid
severe symptom with infant botulism
respiratory arrest
diagnosis of infant botulism
toxin in feces
treatment of botulism
Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G)-(Equine)
Supportive measures: maintain respiration
Baby Botulism Immune Globulin (BIG-IV) for A & B toxins
toxin in long acting mushroom
amantia
incubation period for long acting mushroom and symptoms
4-8 hrs
diarrhea, abdominal cramps, can be fatal
toxin in short acting mushroom
Museinol, Muscarine, Psilocybin, Coprius artemetaris, Ibotenic acid
incubation period for short acting mushroom and symptoms
less than 2 hours
vomiting diarrhea
what are mycotoxigenic fungi toxins
mycotoxin: 2ndary metabolites – aspergillus, fusarium, penicillium
aflatoxin: aspergillus flavus and a. parasiticus
foods responsible for mycotoxigenic fungi toxins
tree nuts, peanuts, oilseeds (corn and cotton)
complications of mycotoxigenic fungi toxins
acute necrosis, cirrhosis, and carcinoma (liver)
toxin in ciguatera poisoning
Dinoflagellates: Gambierdiscus toxicus: Ciguatoxin
types of sea creatures involved in ciguatera poisoning
Large predatory reef fish: barracuda, grouper and amberjacks
symptoms of ciguatera poisoning
3-6 hrs after ingestion
big thing: hot/cold temp reversal and watery diarrhea
watery diarrhea, nausea, abdominal pain
circumoral, and extremity paresthesia, severe pruritus, hot/cold temp reversal
bacteria involved in scombroid poisoning
Stenotrophomonas maltophilia, M. morganii
what do the bacteria in scombroid poisoning do
turn histadine –> histamine which is a scrombotoxin
types of sea creatures involved in scombroid poisoning
Scrombridae Fish: tuna, mahi-mahi, marlin and bluefin
first symptom in scombroid poisoning
metallic taste in mouth
other symptoms of scombroid poisoning
watery diarrhea, nausea, dizziness, urticaria (rash), facial flushing, generalised pruritus, paresthesias
