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10 Cards in this Set

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The most severe form of this disease results from the inhalation of spores with mediastinitus, pulmonary edema and hemorrhage (Woolsorter's Disease)
Bacillus Anthracis - Aerobic

Infection via endospores, soil or animal products Herbivores (cows,sheep)textiles

Cutaneous, Pulmonary, GI

pXO1 plasmid =3 Exotoxins
EF - increases cAMP, edema
PA - promotes EF entry
LF - macs release TNF alpha, IL1
pXO2 plasmid = poly glutamyl capsule (protein capsule)

Tx: Penn, erythromycin, doxyclyclin, ciprofloxacin, levofloxacin
Prophylaxis: Vaccine of PA
Causes gastroenteritis and is typically associated with the consumption of reheated rice.
Bacillus Cereus - Aerobic

Motile, non-encapsulated, penn resistant

Enterotoxins - increase cAMP
Heat labile - similar to E.coli
Heat Stable - similar to S.aureus
H+ Flagella

Tx: Vancomycin, clindimycin
Beta lactam resistant

B. serious, no antibiotics for enterotoxins!
Associated with the use of broad spectrum antibiotics and the overgrowth of toxin producing bacteria

Ampicillin/Amoxycillin, clindamycin, cephalosporins
Clostridium Difficile - Anaerobic

Pseudomembranous Enterocolitis

Exotoxins
A - Diarrhea
B - Cytotoxic

Dx: toxins in the stool
Tx: Metronidazole, Vancomycin
Can cause risus sardonicus, the characteristic grimace of lockjaw (trismus). Infection is associated with traumatic inoculation of spores that germinate and produce a toxin that causes a spastic paralysis.
Clostridium Tetani - Anaerobic

Tennis racket spore

Exotoxin: Tetanospasmin, prevents Renshaw cell interneurons from releasing GABA and glycine = SPASTIC PARALYSIS

Tx: antitoxin + antispasmodics like benzodiazepines
Prophylaxis: Vaccine DPT. Admin at 2,4,6,18 months + every 10 yrs
Pt Types:
>10yrs = give booster
Never had vaccine = give booster + ab to tetnus toxin
Tetnus = give ab, clean, penn, supportive therapy
Disease can be due to the ingestion of preformed toxin in home canned foods or by the ingestion of spores in honey by an infant
Clostridium Botulinum - Anaerobic
Neurotoxin blocks Ach release (xs sympathetic response)

Adult:
FLACCID PARALYSIS, Respiratory failure, diplopia, dyphagia
Cranial nerve palsy, mm weakness
Tx: Antitoxin, Penicillin, Hyperbaric O2, Supportive Ventillation, intubation

Infant: Constipation, floppy baby Tx: supportive therapy
The only bacteria with a capsule composed of protein
Bacillus anthracis

pOX2 plasmid - poly glutamyl capsule
Cutaneous infection results in a painless round black lesion with an edematous rim. (malignant pustule)
Bacillus anthracis

Lesion caused by exotoxin

pXO1 plasmid =3 Exotoxins
EF - increases cAMP, edema
PA - promotes EF entry
LF - macs release TNF alpha, IL1
Woolsorter's Disease
Pulmonary Bacillus anthracis infection causes mediastinal widening due to mediastinal hemorrhage and pleural effusions from macrophage migration to lymph node.
Necrotic lesion on intestine causing bloody diarrhea, vomiting and abdominal pain
GI Bacillus anthracis infection due to exotoxin release.

pXO1 plasmid =3 Exotoxins
EF - increases cAMP, edema
PA - promotes EF entry
LF - macs release TNF alpha, IL1
Causes gas gangrene and is often associated with automobile and motorcycle accidents
Clostridium Perfringens - anaerobic
Lecithinase

Cellulitis - crepitus
Clostridial Myonecrosis - mm life threatening, black fluid

Tx: debridement, pennicillin, hyperbaric O2