Tetanus/Botulism/Fungal-Parasite CNS (lec 17)

Question 1

Clostridium microbe characteristics?

Answer 1

G+ bacilli
Spores
Exotoxins

Question 2

c. tetani microbe characteristics?

Answer 2

G+ bacilli
Terminal spores
Plasmid toxin

Question 3

Tetanus epidemiology?

Action?

Answer 3

soil, human/animal feces

bacteria remains at infection site
toxin released -> absorbed by nn

Disrupts central motor, autonomic fxn, NMJ

Question 4

Tetanus presentation?

Answer 4

mm spasms:
lockjaw/grimace
arched back
flexed arms
extended legs

resp/cardiac fail

Question 5

Tetanus tx?

Answer 5

PCN + antitoxin

Question 6

c. botulinum microbe characteristics?

Answer 6

G+ bacillus
Subterminal spores
High heat resistance
Neurotoxin

Question 7

Botulism types?

Answer 7

Wound
Food
Infant (lethal)

Question 8

Botulism sxs?

Answer 8

double/blurred vision
droopy face
slurred speech
↓ swallowing
mm weakness

Question 9

Botulism diagnostics?

Answer 9

fecal toxin screen

Question 10

Botulism tx?

Answer 10

antitoxin

(U) NO abx

Question 11

Cryptococcus neoformans epidemiology?

Answer 11

reservoir: soil, bird poop
transmission: inhalation (not communicable)
dz: cryptococcosis

Question 12

C neoformans microbe characteristics?

Answer 12

encapsulated yeast

sugar agar = creamy, mucoid colonies

Question 13

C neoformans Virulence Factors?

Answer 13

Capsule: Ø phago
Diphenol oxidase
Grows @ body temp

Question 14

Cryptococcosis action?

Answer 14

skin or pulmonary infection -> CNS

meningoencephalitis

Question 15

Cryptococcosis diagnostics?

Answer 15

Sample from CNS, lesions, etc
Cx: SDA or PDA
Serology = capsule intigen in CSF or latex agglut

Question 16

Cryptococcosis tx?

Answer 16

ampho B

lifetime flucon prophy in AIDS

Question 17

Toxoplasmid gondii causes?

Answer 17

toxoplasmosis

Question 18

T. gondii microbe characteristics?

Answer 18

Trophozoites:
Acute dz - tachyzoite
Chronic - bradyzoite

Cysts:
Tissue - zoitocyst
Sexual stage - oocyst

Question 19

Congenital toxoplasmosis presentation?

Answer 19

Triad:
chorioretinitis (inflamm of eye)
hydrocephalus
intracranial calcification

Question 20

Postnatal toxoplasmosis presentation?

Answer 20

fever, myalgia, blurred vision

Question 21

Toxoplasmosis epidemiology?

Answer 21

hot, humid
foodborne, animal, congenital
(U) NO p-to-p

Question 22

T. gondii diagnostics?

Answer 22

Can identify zoitocysts or trophozoites

ELISA = IgG/IgM in preggos
PCR = parasite DNA in amniotic
CSF parasite isolation

Question 23

Toxoplasmosis tx?

Answer 23

AIDS pts: lifelong Pyri + sulfadia

Question 24

Naegleria fowleri basics?

Answer 24

protozoan
soil, fresh water
causes brain infections

Question 25

Naegleria fowleri microbe characteristics?

Answer 25

Cyst Single Nucleated (from amoeboid form)

Trophozoites:
Flagellate - infective form
Amoeboid - reproductive form, destroys tissue

Question 26

N. fowleri action?

Answer 26

flagellate form enters nose ->
∆ to amoeboid ->
olfactory n to brain ->
necrosis olfac bulbs and brain
(meningoencephalitis) ->
rapid fatality

Question 27

N. fowleri diagnostics?

Answer 27

CSF
Wet mount = amoeba
Tissue bx = tropho
e.coli agar = clear zones

Question 28

N. fowleri DOC?

Answer 28

Amph B + Rif + Miconazole

Question 29

Acanthamoeba castellani/culbertsoni microbe characteristics?

Answer 29

Tropho = spiked pseudopod, infective
Cyst = survival

Question 30

Granulomatous Amoebic Meningencephalitis action?

Sxs?

Tx?

Answer 30

inhaled/wounds cysts -> hemato to brain ->
parenchymal edema -> death 7-120 days (100% fatal)

mental, neuro, flu

pentamidine + ketoconazole

Question 31

Ocular Acanthamoebiasis Keratitis/Uveitis action?

Tx?

Answer 31

trauma cysts into eye
resembles herpes

oral itraconazole + topical miconazole + corticosteroid