Bacterial Diseases

Question 1

what is tetanus?

Answer 1

An acute infectious disease caused by
spores from the bacterium
Clostridium tetani

Question 2

what type of bacteria is c. tetani?

Answer 2

anaerobic, gram-positive

bacillus

Question 3

appearance of c. tetani

Answer 3

“drum stick” appearance

Question 4

transmission of c. tetani

Answer 4

• spores found everywhere in environment

- develop into bacteria when it enters the body (usu through breaks in the skin)

Question 5

what is unique about tetanus?

Answer 5

although it’s preventable w/ vaccine, it’s not spread person to person

Question 6

c. tetani pathogenesis

Answer 6

• spores colonize a deep puncture wound
• in the presence of anaerobic conditions, it produces tetanus toxins
• diffuses away from the would and enters the blood stream and lymph system
• toxins act on neurons that control the nueral feedback that tells flexed musces to relsx
• prevents theses neurons from signaling the relaxation

Question 7

incubation period of c. tetani

Answer 7

3-21 days (avg. 5-10)

Question 8

3 clinical forms of tetanus

Answer 8

• generalized
• localized
• cephalic

Question 9

generalized tetanus s/sx

Answer 9

• MC
• spasm of masseter (lockjaw)
• HA
• muscle spasms
• jerking or staring
• dysphagia/drooling
• painful muscle stiffness
• diaphoresis

Question 10

localized tetanus s/sx

Answer 10

-muscle spasms in a confined area close to the site of the injury

Question 11

cephalic tetanus s/sx

Answer 11

• assocated w/ lesions of the head/face and OM

- results in flaccid cranial nerve palsies rather than spasm

Question 12

dx of tetanus

Answer 12

clinical - no lab tests

Question 13

tx of tetanus

Answer 13

• medical emergency
• immediate tx w/ human tetanus immune globulin (TIG)
• agents for muslce spasms
• aggressive wound care
• IVIG can be used

Question 14

prognosis of tetanus

Answer 14

-mortality: worldwide - 50%; untreated adults - 15-60%; neonates - 80-90%

Question 15

how long does the tetanus vaccine last?

Answer 15

10 yrs

Question 16

what is diptheria?

Answer 16

Diphtheria is an infection
caused by the
Corynebacterium
diphtheriae bacterium

Question 17

Corynebacterium

diphtheriae bacteria type

Answer 17

• nonmotile, noncapsulated, club-shaped

- gram-positive bacillus

Question 18

causes of diptheria

Answer 18

• person to person through respiratory droplets
• contaminated personal items, household items
• touching contaminated wound

Question 19

pathogenesis of c. diptheriae

Answer 19

• adheres to mucosal epi cells where the exotoxin (released by endosomes) causes a localized inflammatory rxn then destruction and necrosis
• distruction enables the toxin to be carried lymphatically and hematologically to other parts of the body an can have a systemic effect

Question 20

incubation period of c. diptheriae

Answer 20

• 2-5 days

- can involve any mucous membrane

Question 21

types of diptheria

Answer 21

• respiratory: nasal, pharyngeal and tonsillar, laryngeal

- cutaneous

Question 22

s/sx of diptheria

Answer 22

• thick gray membrane covering your throat and tonsils
• sore throat and hoarseness
• enlarged lymph nodes and bull neck
• difficulty or rapid breathing
• nasal discharge
• fever, chills, malaise

Question 23

cutaneous diptheria

Answer 23

-type of diphtheria can affect the skin,
causing the typical pain, redness and swelling associated with other bacterial skin infections
-Ulcers covered by a gray membrane also may bdevelop in cutaneous diphtheria

Question 24

complications of diptheria

Answer 24

• blocking of airway
• myocarditis
• nervous system toxicity
• pneumonia

Question 25

Dx of diptheria

Answer 25

- pharyngeal gram stain and culture - wound gram stain and culture **don't wait for results to start tx

Question 26

tx of diptheria

Answer 26

- antitoxin (DAT) - abs: penicillin or erythromycin - isolation - vaccination - examine close contacts

Question 27

What is botulism?

Answer 27

``` -a rare, serious, life-threatening disease -caused by a toxin that attacks the body’s nerves and causes difficulty breathing, muscle paralysis and even death -an intoxication not infection -no person to person spread ```

Question 28

bacterium the produces the botulism toxcin

Answer 28

-clostridium botulinum

Question 29

clostridium botulinum bacteria type

Answer 29

-Anaerobic, gram positive, rod-shaped bacteria -Spores normally grow in soil or lake sediments -found on plants growing in feces contaminated soil

Question 30

how many forms of botulinum toxins?

Answer 30

- 7 | - A-G

Question 31

which kinds of toxins cause human botulism

Answer 31

- A - B - E - rarely F

Question 32

50% of food borne botulism outbreaks are from which kinds?

Answer 32

A; then B and E

Question 33

which kinds of botulism cause illness in birds and mammals?

Answer 33

C, D and E

Question 34

infant botulism

Answer 34

caused by ingesting spores of the bacteria which germinate and produce toxin in the intestines (honey)

Question 35

food borne botulism

Answer 35

caused by eating foods that contain botulism toxin

Question 36

wound botulism

Answer 36

C. botulinum spores germinate in the infected tissue

Question 37

inhalation botulism

Answer 37

Aerosolized toxin is inhaled: | ▪ does not occur naturally and may be indicative of bioterrorism

Question 38

home canned goods and risk for botulism

Answer 38

-particularly low-acid foods such as asparagus, beets, and corn

Question 39

honey and risk for botulism

Answer 39

- can contain C. botulinum spores | - not recommended for infants <12 months old

Question 40

pathogenesis of botulism

Answer 40

-toxin enters blood stream from wound or mucosal surface --> binds to peripheral cholinergic nerve endings --> inhibits release of Ach --> prevents muscles from contracting --> symmetrical, descending, flaccid paralysis from cranial nerve downward

Question 41

complications of botulism

Answer 41

-Can result from airway obstruction or paralysis of respiratory muscles -Secondary complications related to prolonged ventilatory support and intensive care

Question 42

Sx of botulism

Answer 42

- n/v - HA - diplopia - droopy eyelids - dysphagia - dilated/fixed pupils - extremely dry mouth - can progress to paralysis and respiratory weakness

Question 43

infants w/ botulism will present with what sx?

Answer 43

- constipation - weak cry - poor feeding - poor muscle tone - "floppy baby" syndrome

Question 44

botulism dx

Answer 44

- toxin bioassay - sometime EMG - toxin can be identified by: serum, stool, vomit, gastric aspirate, foods, wound culture

Question 45

botulism tx

Answer 45

- botulinum antitoxin, heptavalent (HBAT) - > 1yo - supportive care - elimination - abx for wound - monitor

Question 46

therapeutic uses of botulism toxin

Answer 46

- focal dystonias - spasticity - nondystonic disorders - strabismus - disorders of localized muscle spasms - smooth muscle hyperactive disorders - cosmetic - sweating