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Chapter 6: Bacillus and Clostridium

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What are the spore-producing gram positives?
Bacillus and clostridium.
What are the types of bacillus? What diseases do they cause?
Bacillus anthracis – anthrax. Bacillus cereus – food poisoning.
What are the ways anthrax-causing spores can be introduced into the body?
Germination on skin abrasions, inspiration into the lungs, ingestion into the GI tract.
Describe the progression of pulmonary anthrax?
Spores are taken up by lung macs and transported to the hilar and mediastinal lymph nodes. Mediastinal hemorrhage causes mediastinal widening and pleural effusions.
Contrast bacillus cereus with bacillus anthracis? What does it cause?
Motile, non-encapsulated, and resistant to penicillin. Causes food poisoning when it deposits its spores in food.
List the clinically relevant species of clostridium?
C. botulinum, c. tetani, c. perfringens, and c. dificile.
Describe botulism? Adult vs infant manifestations?
Extremely lethal neurotoxin – causing flaccid muscle paralysis. In adults, you will see development of bilateral CN palsies followed by general weakness and a rapid progression to respiratory paralysis. In infants, prognosis is much better.
Clinical symptoms of tetanus?
Trismus (lockjaw), risus sardonicus, sustained tetanic contraction.
Describe treatment of a patient who comes to the hospital having already developed tetanus?
Neutralize circulating toxin with human tetanus immune globulins. Give an immunization booster. Clean the wound. Administer penicillin. Provide intensive supportive therapy.
C, perfringens infection is aka⬦? List the classes of infection with C. perfringens?
Gas gangrene. Cellulitis/wound infection. Clostridial myonecrosis.
C dificile causes⬦? Clinical manifestations?
Antibiotic-associated pseudomembranous colitis (diarrhea) following the use of broad spectrum antibiotics. Characterized by severe diarrhea, abdominal cramping, and fever.
How is C dificile treated?
Neither metronidazole or vancomycin are absorbed orally into the bloodstream. Administration by mouth cause the METRO and VAN to cruise down the GI tract to kill the bacteria.

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