CUTANEOUS exotoxin causes localized tissue necrosis eschar formation w/ edema RESPIRATORY woolsorter's disease PULMONARY HEMORRHAGE - cause of death - hemorrhagic mediastinitis - WIDENED MEDIASTINUM GI rare but fatal ingestion of infected meat

SPORE FORMING GRAM POSITIVE RODS Flashcards by Jamaira Belmes

Bacterial Spore Position

CENTRAL

Bacillus anthracis

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Bacterial Spore Position

TERMINAL

Clostridium tetani

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Bacterial Spore Position

SUBTERMINAL

Clostridium botulinum

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Only bacteria w/ AMINO ACID CAPSULE (D-glutamic acid)

Bacillus anthracis

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McFadyean Reaction

polychrome methylene blue – capsule appear PINK
body appear DARK BLUE

Bacillus anthracis

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ANTHRAX

CUTANEOUS

exotoxin causes localized tissue necrosis
eschar formation w/ edema

RESPIRATORY

woolsorter’s disease
PULMONARY HEMORRHAGE - cause of death
hemorrhagic mediastinitis - WIDENED MEDIASTINUM

rare but fatal
ingestion of infected meat

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Calmodulin dependent adenylate cyclase

Edema Factor (EF)

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INHIBITS signal transduction in cell division

Lethal Factor (LF)

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Mediates the ENTRY of the other 2 components into cell

Protective antigen (PA)

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Direct epidermal contact w/ spores causes formation of a MALIGNANT PUSTULE w/ subsequent eschar and central necrosis

Cutaneous Anthrax

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Inhaled spores from animals (Woolsorter’s disease) or from weaponized preparations (bioterrorism)

PROLONGED LATENT PERIOD

MASSIVELY ENLARGED MEDIASTINAL LYMPH NODES, pulmonary hemorrhage, meningeal symptoms

Inhalational Anthrax

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Ingestion of live spores leads to UGI ulceration, edema and sepsis

Gastrointestinal Anthrax

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DOC for cutaneous anthrax

CIPROFLOXACIN

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DOC for inhalational anthrax

CIPROFLOXACIN or DOXYCYCLINE w/ one or 2 additional

antibiotics

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Drug used for anthrax

Raxibacumab - binds w/ PA

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The heat resistance of bacterial spores such as those of B. anthracis is due in part to their dehydrated state and in part to the presence of large amounts which of the ff sign?

Calcium dipicolinate

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MCC of death is PULMONARY HEMORRHAGE in the ff:

anthrax (pulmonary) aka woolsorter’s disease

leptospirosis, severe (Weil’s syndrome)

congenital syphilis

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similar to enterotoxin of cholera and LT from E. coli

causes ADP-RIBOSYLATION INCREASING cAMP

causes DIARRHEA

Bacillus cereus
ENTEROTOXINS

heat LABILE

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Staphylococcal-like enterotoxin function as SUPERANTIGEN

causes EMESIS

Bacillus cereus
ENTEROTOXINS

heat STABLE

RICE - SUKA

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Produces the most potent neurotoxin (BLOCKS THE RELEASE OF ACETYCHOLINE from THE PRESYNAPTIC NERVE TERMINALS) – flaccid

Clostridium botulinum

TRIAD OF BOTULISM

symmetric descending flaccid paralysis - w/ prominent bulbar involvement

absence of fever

intact sensorium

Occurs when babies ingest spores found in household dust or honey

d.t. absence of competitive bowel microbes

Infant Botulism (Floppy Baby Syndrome)

Protease that cleaves proteins involved in the release of glycine from Renshaw cells in spinal cord

Prevents release of GABA by cleaving of synaptobrevin 2

GABA and glycine - inhibitory

Tetanospasmin (Tetanus Toxin)

Muscles affected in tetanus toxoid

Risus sardonicus - ORBICULARIS ORIS

Lock jaw (trismus) - muscles of mastication - MASSETER, LATERAL PTERYGOID, TEMPORALIS

Opisthotonos - ERECTOR SPINAE

In a patient sustaining cat bite below the angle of the mandible, 3 mm in size, w/ nonspontaneous bleeding, which of the ff PEP should be given? A. rabies vaccine + rabies Ig B. rabies vaccine + tetanus vaccine C. rabies vaccine + tetanus vaccine + tig D. rabies vaccine + rabies Ig+ tetanus vaccine + tig

D. rabies vaccine + rabies Ig+ tetanus vaccine + tig

Drug for tetanus

METRONIDAZOLE - 400 mg rectally OR 500 mg IV q6 for 7 days Penicillin - ALTERNATIVE

DOUBLE HEMOLYSIS on blood agar EGG YOLC AGAR - nonmotile but with rapidly spreading growth on culture media

Clostridium perfringens

LECITHINASE that cleaves cell membrane and causes GAS GANGRENE

ALPHA TOXIN Clostridium perfringens *Nagler's reaction

Responsible for food poisoning (enteritis necroticans/pig bel disease)

BETA TOXIN | Clostridium perfringens

MCC of superinfection PSEUDOMEMBRANOUS COLITIS severe diarrhea, abdominal cramping

Clostridium (Clostridioides) difficile

Drug of choice in treating pseudomembranous colitis

VANCOMYCIN (PO) -poor intestinal absorption; coats the lesions w/ antibiotics METRONIDAZOLE (PO)

Antibiotics suppress normal flora, allowing C. difficile to overgrow

CLINDAMYCIN AMPICILLIN 2nd and 3rd gen CEPHALOSPORINS

Nonbloody diarrhea associated w/ PSEUDOMEMBRANES (yellow-white plaques) on the colonic mucosa

pseudomembranous colitis

Nontraumatic myonecrosis in immunocompromised patients

C. septicum

Toxic shock syndrome associated w/ septic abortion

C. sordellii

Traumatic wound infections

C. tertium

Edema Toxin

PA + EF = edema toxin

Lethal Toxin

PA + LF

Important virulence factor of Bacillus anthracis

Protective antigen

Young man sustains major soft tissue injury and open fracture of his right leg. One day later he has fever, increased HR, sweating and restlessness. On examination leg is swollen and tenses. The skin if the leg is cool, pale, white and shining. (+) Crepitus serum shows free hemoglobin ``` A. Clostridim tetani B. Staphylococcus aureus C. Escherichia coli D. Bacillus anthracis E. Clostridium perfringens ```

E. Clostridium perfringens PENICILLIN G

Responsible for hemolysis in gas gangrene caused by C. perfringens

LECITHINASE

Reported incubation period for INHALATIONAL ANTHRAX

6 weeks

Food commonly associated w/ Bacillus cereus food poisoning

Fried rice

Tetanus toxin (tetanospasmin) diffuses to terminal of inhibitory cells in the spinal cord and brainstem and blocks

release of inhibitory glycine and GABA

Which of the ff statements about tetanus and tetanus toxoid is correct? A. Tetanus toxin kills neurons B. Tetanus toxoid immunization has a 10% failure rate C. The mortality rate of generalized tetanus is <1% D. Double vision is commonly the first sign of tetanus E. Tetanus acts on inhibitor interneuron synapses

E. Tetanus acts on inhibitor interneuron synapses

Infant botulinum has been associated w/ all of the ff Clostridium species EXCEPT A. Clostridium baratti B. Clostridium septicum C. Clostridium butyricum D. Clostridium botulinum

B. Clostridium septicum

All of the ff are properties characteristic of Bacillus anthracis EXCEPT ``` A. motility on wet mount exam B. medusa head colonies C. poly-D glutamic acid capsule D. in vitro susceptibility to penicillin E. absence of hemolysis on 5% sheep blood agar ```

A. motility on wet mount exam

Large gram positive rod that cause NECROSIS of tissue by producing an exotoxin that DEGRADES LECITHIN -- lysis of cell mebranes

Clorstridium perfringes