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-A Gram negative coccobacilli
- -Genus: Bordetella
- -species: pertussis
- -Disease AKA Pertussis
- -DPaT vaccine last 10-12 years
- -DPT 1949
- -Many adults may develop a mild case, some cases often serious
- -Incubation period 7-10 days
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Bordetella Pertussis - Pathogenesis
- -B.pertussis interferes with the action of the ciliated epithelial cells of the trachea.
- -B. pertussis survives in phagocytes.
- -Pertussis is mainly a pediatric disease reported in children 5 years and younger.
- -Mild cases are common.
- -There is a persistant cough and may be misdiagnosed as bronchitis.
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=Pneumonia, convulsions, bacteremia
- -Brain inflammation (encephalopathy)
- -Possible death in children due to cyanosis
- -Severe coughing can compromise respiration and/or cause vomiting.
- -Individuals may be more susceptible to secondary infections such as TB.
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-Note that a cough which lasts more than 2 weeks may be pertussis and the person is contagious during the coughing stage. -If the case is self limiting, the cough will cease in 3 months.
- -Weight loss may occur due to the excessive coughing and vomiting
- -Often misdiagnosed.
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-Species – influenzae
- -Gram negative pleomorphic bacilli
- -Normal flora of the nasopharynx
- -Specific infections include meningitis, otitis media, otitis interna, epiglottis, infantile arthritis, pharyngitis
- -Note: No Flu
- -1/3 children die, 1/3 suffer brain damage
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-Cone filled with herbs, spices & dried flowers
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Tularemia (AKA Rabbit Fever)
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-Genus: Francisella
- -species: tularensis
- -Gram negative coccobacilli
- -Hosts include mammals, birds, fish, and blood-sucking ticks and insects
- -Most common is US are rabbits, muskrats and ticks
- -No human to human spread
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-Bite of an infected tick or contact with an infected animal
- -Infected animal urine or saliva
- -Consuming infected meat not properly cooked (rabbit or deer)
- -Drinking contaminated water
- -Inhaling bacteria in aerosols
- -Penetrates unbroken shin
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-Ulcers at the site of contact
- -Fever and chills
- -Malaise and fatigue
- -Eye infections
- -Enteritis
- -Swollen lymph nodes
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-AKA Legionnaire’s Disease
- -Genus: Legionella
- -species: pneumophilia
- -Gram negative polymorphic bacilli
- -An epidemic pneumonia affecting 2000 American Legion members at a convention in Philadelphia in 1976.(34,29 deaths).
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-Found growing in the air-conditioning vents at the Hotel (condensation)
- -Transmission
- -Humans acquire the disease by inhaling the organism from aerosols such as showers, vaporizers, spa, whirlpools, hot tubs, air conditioning systems, cooling towers and grocery store misters
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-Clostridia and Bacteriodes Characteristics
- -A. All discharges have a foul odor.
- -B. The toxins produce a lesion of necrosis.
- -C. A bubbling effect with gas production.
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Tetanus (AKA lockjaw) DPaT
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-Genus: Clostridium
- -Species: tetani
- -Gram positive terminal spore forming bacilli
- -Found in dust, soil and GI tracts of animals and humans
- -Its vegetative cells are sensitive to oxygen
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-Spores must enter a wound, especially wounds contaminated by soil or feces.
- -When C. tetani cells in the body die, a potent neurotoxin is produced.
- -Neurons phagocytize the toxin.
- -The toxin works its way to the inhibitory neurons and prevents muscle relaxation.
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-Begins 3 days to 3 weeks after infection exposure (spores germinate)
- -First sign is a headache followed by spasms of the jaw.
- -Sweating, drooling, grouchiness, heart beat irregularities and constant back spasms
- -Bones may break; respiratory failure; 50% of patients die
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-Genus: Clostridium
- -species: botulinum
- -Infection may be food-borne, infant and wound
- -Gram positive spore forming bacilli. Common in soil and water.
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-Botulism toxins act by binding irreversibly to neuronal cytoplasmic membranes, thereby preventing the fusion of Ach vesicles to the membrane and the release of Ach into the synapse.
-The neurotoxins prevent muscle contraction.
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-Improperly canned food
- -Honey fed to children and infants
- -Contaminated soil and water
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-Ingestion of spores, which then germinate and colonize their GI tract.
- -Infant GI tract does not have the proper benign bacteria to compete with C. botulinum for nutrients and space
- -Lethargy, mild paralysis and SIDS may result.
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-Begins 4 to more days following the contamination of a wound by spores.
- -Unhealed naval of an infant, IV drug users and nasal cocaine users (spores enter the nose)
- -Cutting cocaine: baby powder, laxatives, comet, ajax, powered sugar, etc.
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-Consumption of the toxin from contaminated home canned foods or preserved fish
-Food may not appear or smell spoiled.
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-Blurred and double vision
- -Thick speech
- -Difficulty breathing and swallowing
- -Paralysis similar to stroke (diaphragm)
- -Hemorrhage
- -Dilated pupils
- -Constipation
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-Antitoxins
- -Boil canned foods for 15 minutes (kills bacteria and inactivated the toxin)
- -Antimicrobial drugs
- -Antibodies
- -Repeated washing of the intestinal tract
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-Botox is a weakened form of the toxin
- -Scientists consider Botulism toxins the deadliest of all toxins.
- -30 grams (1 oz) of the pure toxin would kill all persons in the US.
- -The toxin blocks the release of Ach and muscles are unable to contract.
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-Genus: Clostridium
- -Species: perfringes
- -Gram positive spore forming bacilli
- -Produces 11 toxins that damage RBCs, WBCs, muscle connective tissue
- -Vascular permeability is also increased
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C. perfringes transmission
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-Food poisoning: food contaminated with feces and soil
- -Wound infections: spores entering a wound
- -Surgical incision, a puncture, a gunshot wound, crushing trauma, or a compund fracture
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Food Poisoning:
- -Abdominal pain and watery diarrhea
- -No fever, nausea or vomiting
- Wound infection:
- -Myonecrosis (death of muscle and connective tissue)
- -Shock, kidney failure and death may result
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-Genus: Clostridium
- -species: difficile
- -Spore forming bacilli
- -An inhabitant of the intestinal tract
- -Occurs only when antibiotic therapy alters the normal intestinal flora, allowing overgrowth of toxin producing C. difficile
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-Normal intestinal flora inhibit C.difficile multiplication
- -Antibiotics destroy intestinal flora and C. diff. will multiply.
- -C. difficile infections cause diarrhea, fever, abdominal pain and may lead to fatal colitis.
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-Immunosuppressed patients, prolonged hospital recovery ,young children and infants are at high risk for C. diff. diarrhea
- -C. diff. releases damaging toxins
- -C. diff. causes ½ of all nosocomial related infections
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