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Anthrax
Clostridial diseases
Clostridium
Gram
spp.
positive rods
Obligate anaerobes
Endospore forming
Clostridium spp.
Endospores
Resistant
to:
Heat
Disinfectants
Clostridium spp.
Soil
oxygen
Superoxide free radicals
Clostridium perfringens
C.
Clostridium difficile
Pseudomembranous
colitis in humans
is caused by overgrowth ofClostridium
difficile in the colon, usually after the
normal flora has been disturbed by
antimicrobial chemotherapy.
C. difficile produces two toxins: Toxin A is
referred to as an enterotoxin because it
causes fluid accumulation in the bowel
Toxin B is an extremely lethal (cytopathic)
toxin.
Clostridium tetani
Clostridium
Neutralization of oxygen
radicals
Superoxide Dismutase
(SOD)
Catalase
Clostridium spp. lacks these
enzymes
Clostridium spp.
C. tetani
C. botulinum
C. perfringens
C. difficile
Clostridium tetani
Drumstick appearance
Clostridial diseases
Tetanus
Botulism
Gas
gangrene
Foodborne gastroenteritis
Pseudomembrane colitis
TETANUS
Localized
infection,
caused by a C.tetani toxin
General muscle spasmsdue to neurotoxin
TETANUS (cont.)
Trauma
(often trivial)
Chronic skin ulcers
Umbilical cord (clay
matter ritual in Africa)
Abortion (unsanitary
abortions)
TETANUS (cont.)
300,000/year
world wide
100 cases/year in the USA (24
fatal)
70% unvaccinated, or
incomplete vaccination regime
Mostly 60 years and older
TETANUS (cont.)
Spores
in wound
Infection and/or tissue
necrosis
Low O2 tension
Spore germination
TETANOSPASMIN
Blocks
the muscle
relaxation pathway
Death results from spasms
of respiratory muscles
Released from dead
bacterial cells
TETANOSPASMIN (cont.)
Once
it attaches to
nerves, therapy is usually
ineffective
TREATMENT OF TETANUS
Removal
of necrotized
(death) tissue
Antibiotics
Human
immunoglobulins
TETANUS VACCINE
Toxin
Toxoid
Enzyme
-S-SActive
Inactive
TETANUS VACCINATION
SCHEDULE (CDC)
DTaP
vaccine (Diptheria,
Tetanus & acellular
pertussis)
2, 4, 6 and 12-18 months
4-6 years
FOODBORNE BOTULISM
A
non-infectious food
poisoning
C. botulinum neurotoxin
in contaminated food
34 cases in 1994 (USA)
FOODBORNE BOTULISM
(cont.)
BOTULIN TOXIN
Most
Definitive Diagnosis
only
BOTULISM PREVENTION
Preservation of foods at pH
below 4.7
Salt (brine) and sugar
Nitrites in cured foods
(remember the nitrites/nitrates in
hot dogs, cured ham, processed
meats)
Boiling food 10 min
INFANT BOTULISM
Predominant
WOUND BOTULISM
C.
botulinum develops in
grossly contaminated wounds
19 cases in 1995
Very common with black tar
heroine users/skin popping
What is Blepharospasm?
Blepharo means "eyelid". Spasm
means "uncontrolled muscle
contraction".
The term blepharospasm can be
applied to any abnormal blinking or
eyelid tic or twitch resulting from any
cause, ranging from dry eyes to
Tourette's syndrome to tardive
dyskinesia.
What is Strabismus?
GAS GANGRENE
GAS GANGRENE
Tissue
Gas gangrene
Clostridium perfringens
lethal if untreated
C. perfringens ferments muscle proteins
and carbohydrates producing H2 and CO2
Predisposing factors:
Dirt
in wound
Long delay before wound care
Induced abortion
factors:
Arteriosclerosis
Diabetes
Gas
gangrene
in arm
Gas gangrene
in foot
Gas
gangrene
in foot
TREATMENT
Removal
Amputation
Hyperbaric
Antibiotics
O2
Anthrax
Anthrax
Caused
Robert
Koch-1876, 1877
isolated and obtained a pure
culture
Louis Pasteur-1881, developed
a vaccine
Robert Koch
Koch
Robert Koch
In
Anthrax vaccine--Pasteur
In
Gram Stain-Gram
Positive
Robert
Kochs
Photos
Human
Three
forms:
Cutaneous-Most common form
acquired through a cut or abrasion of the
skin, which comes into contact with spores
from the soil or a contaminated animal
Inhalationacquired by the inhalation of sporecontaining dust where animal hair or hides
are handled
Intestinal- (Speculated)
consumption of contaminated meat
Cutaneous-Spores
Cutaneous Anthrax
Treatment:
Antibiotics
Effective
Anthrax
Biological Warfare
Any