Clostridium perfringens: Difference between revisions
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Clostridium perfringens
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+ | == Background == |
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− | == |
+ | ===Microbiology=== |
− | * |
+ | *Often encapsulated short Gram-variable bacilli of varying length |
− | * |
+ | *Found in soil and human (and animal) [[Gut microbiota|gut flora]] |
− | * |
+ | *Makes necrotizing extracellular toxins |
+ | *Multiple types, based on production of major toxins, though only type A (and rarely type C) cause disease in humans |
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+ | **Toxins include alpha-toxin (CPA), beta-toxin (CPB), epsilon-toxin (ETX), iota-toxin (ITX), enterotoxin (CPE), and necrotic enteritis B-like toxin (NetB) |
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+ | {| class="wikitable" |
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+ | !Type |
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+ | !Toxins |
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+ | !Clinical Notes |
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+ | |- |
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+ | |A |
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+ | |CPA only |
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+ | |foodborne illnesses associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel |
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+ | |- |
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+ | |C |
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+ | |CPA and CPB ±CPE |
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+ | |pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum), particularly in Papua New Guinea |
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+ | |- |
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+ | |all others |
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+ | |Various |
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+ | |do not cause disease in humans |
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+ | |} |
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+ | |||
+ | === Epidemiology === |
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+ | |||
+ | * Spores can survive cooking at normal temperatures |
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+ | * Foodborne illness is usually associated with improperly heated or reheated gravy, beef, poultry, or other meat |
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+ | |||
+ | == Clinical Manifestations == |
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+ | |||
+ | * Acute infectious diarrhea |
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+ | * Abdominal sepsis |
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+ | * Cellulitis and myonecrosis |
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+ | |||
+ | == Management == |
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+ | |||
+ | * For gas gangrene, typically requires surgical debridement and [[penicillin G]] |
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+ | ** Consider adding [[clindamycin]] for theoretical decreased toxin production in [[toxic shock syndrome]] |
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+ | * Otherwise, generally susceptible to [[erythromycin]], [[chloramphenicol]], [[cefazolin]], [[cefoxitin]], [[ceftriaxone]], [[piperacillin]], [[carbapenems]], [[metronidazole]], [[vancomycin]], and [[linezolid]] |
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+ | [[Category:Gram-positive bacilli]] |
Latest revision as of 10:15, 22 June 2023
Background
Microbiology
- Often encapsulated short Gram-variable bacilli of varying length
- Found in soil and human (and animal) gut flora
- Makes necrotizing extracellular toxins
- Multiple types, based on production of major toxins, though only type A (and rarely type C) cause disease in humans
- Toxins include alpha-toxin (CPA), beta-toxin (CPB), epsilon-toxin (ETX), iota-toxin (ITX), enterotoxin (CPE), and necrotic enteritis B-like toxin (NetB)
Type | Toxins | Clinical Notes |
---|---|---|
A | CPA only | foodborne illnesses associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel |
C | CPA and CPB ±CPE | pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum), particularly in Papua New Guinea |
all others | Various | do not cause disease in humans |
Epidemiology
- Spores can survive cooking at normal temperatures
- Foodborne illness is usually associated with improperly heated or reheated gravy, beef, poultry, or other meat
Clinical Manifestations
- Acute infectious diarrhea
- Abdominal sepsis
- Cellulitis and myonecrosis
Management
- For gas gangrene, typically requires surgical debridement and penicillin G
- Consider adding clindamycin for theoretical decreased toxin production in toxic shock syndrome
- Otherwise, generally susceptible to erythromycin, chloramphenicol, cefazolin, cefoxitin, ceftriaxone, piperacillin, carbapenems, metronidazole, vancomycin, and linezolid