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Mycobacterium group
Mycobacterium tuberculosis
Droplet inhalation
Ingestion of contaminated milk and milk
products
Kissing
Skin contact
Constitutional signs and symptoms
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Immunity
Cellular immunity controls growth and
spread of bacteria while humoral immunity
is short-lived and non-productive
BCG (Bacillus of Calmette and Guarin)
vaccine is given ID, usually at birth
Tuberculin test (Mantoux test) detects the
exposure to the bacilli
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Diagnosis
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Other methods:
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Mycobacterium leprae
Commonly known as Hansen’s bacillus
Acid fast bacilli arranged in pallisade
Obligate intracellular organisms
Grown only in a biologic medium: in foot
pads of mice, chimps, armadillo
Mycobacterium leprae: The Leprosy
22
Bacillus
Strict parasite – has not been grown on
artificial media or tissue culture
Slowest growing of all species
Multiplies within host cells in large
packets called globi
Causes leprosy, a chronic disease that
begins in the skin and mucous
membranes and progresses into nerves
Epidemiology and Transmission of
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Leprosy
Endemic regions throughout the world
Spread through direct inoculation from
leprotics
Not highly virulent; appears that health
and living conditions influence
susceptibility and the course of the
disease
May be associated with specific genetic
marker
Course of Infection and
Disease
24 Macrophages phagocytize the bacilli, but
a weakened macrophage or slow T cell
response may not kill bacillus.
Incubation from 2-5 years; if untreated,
bacilli grow slowly in the skin
macrophages and Schwann cells of
peripheral nerves
2 forms possible:
tuberculoid – superficial infection without skin
disfigurement which damages nerves and causes
loss of pain perception
lepromatous – a deeply nodular infection that
causes severe disfigurement of the face and
extremities
Diagnosis
26
Lepromatous type
(-)
tuberculin test
Poor cellular response to infection
Poor prognosis
Management
Dapsone: mainstay of management,
lifetime maintenance
Rifampicin
Ethionamide
Other mycobactrium
Mycobacterium kansasii
Photochromagen: produce pigments in
light but not in the dark
Produce tuberculosis-like symptoms
Mycobacterium avium-
intracellulare
Produce little pigment
Produce overt tuberculosis among AIDS
patients
opportunistic
Mycobacterium avium-
intracellulare
Mycobacterium scrofulaceum
Scotochromagen: produce pigments when
grown in the dark
Saprophytic in adults with chronic lung
disease
Produce scrofula in young children with
cervical lymphadenitis
Mycobacterium marinum et
ulcerans
Occurs in water contaminated by bird
droppings
Causes swimming pool granulomas
(superficial skin ulcers)
Mycobacterium fortuitum et
cheloni
Rarelyproduce systemic and superficial
disease in man
Contaminates porcine valves used in
human cardiac surgery
Bacillus group
Bacillus anthracis
Forms long chains giving a bamboo pole
appearance
Spore formers
grown in blood agar medium forming
medusa head colonies
Zoonotic infection
Bacillus anthracis
Pathogenesis
Causes anthrax
Types of anthrax
Cutaneous anthax: manifest with malignant
skin pustules
Pulmonary anthrax: woolsorter’s disease
Intestinal anthrax: enteritis
Cutaneous Anthrax
The most common naturally occurring form of
anthrax.
Ulcers are usually 1-3 cm in diameter.
Incubation period:
Usually an immediate response up to 1 day
Case fatality after 2 days of infection:
Untreated (20%)
With antimicrobial therapy (1%)
Cutaneous Anthrax
Abdominal anthrax is
more common than the
oral-pharyngeal form.
http://science.howstuffworks.com/anthrax1.htm
GI Anthrax
GI anthrax cases are uncommon.
There have been reported outbreaks in Zimbabwe,
Africa and northern Thailand in the world.
GI anthrax has not been reported in the US.
Incubation period:
1-7 days
Case fatality at 2 days of infection:
Untreated (25-60%)
With antimicrobial therapy (undefined) due to the rarity
Treatment
Before 2001, 1st line of
treatment was penicillin G
Stopped for fear of
genetically engineered
resistant strains
60 day course of antibiotics
Other Drugs
Ciprofloxacin
Doxycycline
For inhalational, need another
antimicrobial agent
clindamycin
rifampin
Chloramphenicol
http://nmhm.washingtondc.museu Vaccine
m/news/anthrax.html
Toxoid (protective antigen)
Effective in short term but not
long term
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Laboratory identification
Stain
Culture
Ascoli’s test- precipitin band ring
Management
Penicillin G
Vaccine
Premier et Diexeme vaccine
Sobernheim vaccine
Sterne vaccine
Other bacillus
B. cereus
B. subtilis
B. thuringensis
B. polymyxa
B. licheniformis
Bacillus cereus
55
Common airborne and dustborne; usual methods of
disinfection and antisepsis are ineffective
Grows in foods, spores survive cooking and
reheating
Ingestion of toxin-containing food causes nausea,
vomiting, abdominal cramps and diarrhea; 24 hour
duration
No treatment
Increasingly reported in immunosuppressed
Clostridium group