Gram Positive Endospore Forming Infections

Question 1

Bacillus anthracis causes…

Answer 1

Cutaneous Anthrax (skin/skeletal)

Pulmonary Anthrax (respiratory)

Question 2

Clostridium perfringens causes…

Answer 2

Gas Gangrene (skin/skeletal)

Question 3

Clostridium tetani causes…

Answer 3

Tetanus (nervous/muscle)

Question 4

Clostridium difficile causes…

Answer 4

Diarrhea and colitis (gastro)

Question 5

Clostridium botulinum causes…

Answer 5

Botulism (nervous/muscle)

Question 6

Bacillus anthracis characteristics

Answer 6

facultative anaerobe

soil reservoir

Question 6

Anthrax

Answer 6

zoonotic disease of grazing animals (ex: cattle, sheep)

Cutaneous Anthrax
Tm: spores enter skin abrasion (ID = 10-50)
papule becomes necrotic and gives rise to a painless
black eschar
20% mortality if untreated
Tx: none, resolves on its own

Pulmonary Anthrax
Tm: inhalation of spores (ID = 8,000 – 50,000)
edema toxin causes local swelling that interferes with phagocytosis
lethal toxin kills macrophages and releases lysosome contents
capillary thrombosis, CV shock, 99% mortality if untreated
Tx: abx and Abs

Question 7

Clostridium Characteristics

Answer 7

obligate anaerobes

soil reservoir

Question 8

Gas Gangrene

Answer 8

Tm: surgical incisions, fractures, puncture wounds

hyaluronidase and collagenase invade the tissue

alpha-toxin kills RBCs and causes edema and tissue death

anaerobic condition due to limited blood supply

gas forms from fermentation

Tx: debridement, amputation, hyperbaric chamber,
abx

Question 9

Tetanus

Answer 9

Tm: puncture wounds, crushed body parts

tetanospasmin

lock-jaw, risus sardonicus, opisthotonos

Spartic paralysis - death by respiratory failure

Tx: DTaP, Td and TT vaccine; TIG

Question 10

C.diff

Answer 10

acquired from abx use (antibiotic-associated colitis) and/or gastric acid inhibitors

enterotoxins kill intestinal cells, resulting in diarrhea

colitis may form pseudomembranes

cecal perforation may result in death

Tx: vancomycin, FMT

Question 11

Botulism

Answer 11

Tm: ingestion of contaminated improperly
canned or preserved food, honey

(botulinum toxin intoxication)

botulinum toxin

Question 12

2 types of Botulism

Answer 12

1. Infant botulism
   Tm: ingestion of spores, but immune
   the system is not fully developed
   Flaccid paralysis
   death by respiratory failure
2. Wound botulism
   Tm: growth in the wound; rare
   Tx: abx, antitoxin Ab