Kingdom: Bacteria Phylum: Firmicutes Class: Bacilli Order: Bacillales Family: Bacillaceae Genus: Bacillus

Bacillus
Bacillus anthracis & Bacillus cereus

Bacillus Anthrax
Very large, Gram-positive, spore forming rod (Box Car)
Very similar to Bacillus cereus hemolysis

Capsule - glutamyl-polypeptide protein

Bacillus cereus

Bacillus anthracis

Virulent factors
Poly-D-glutamyl capsule:
Inhibits phagocytosis & compliment , smooth mucoid colonies Not seen in other bacillus Helps in initial infection

Anthrax toxin:
Plasmid-mediated, heat-labile toxin Protective antigen:
Binds to surface receptor. It is antigenic, and host-response yields protective antibodies (protective against toxin -- not against the bug)

Edema Factor:
Bug-derived adenyl cyclase enters host cell cAMP electrolyte and water loss.

Lethal Factor:
Metalloprotease enters and kills host cells. Mechanism unknown

Two microscopic techniques to demonstrate the presence of the poly-D-glutamyl capsule of Bacillus anthracis. Left. India ink capsule outline 1000X. Right a fluorescent-labeled antibody is reacted specifically with the capsular material which renders the capsule fluorescent - FA stain 1000X

Courtesy By Dr.Kenneth Toder

Courtesy by American society of investigations

Anthrax Toxin

Epidemiology
Zoonotic (horse, goats, sheep, cattle, etc.)

Contaminated soil
Contaminated food Contaminated fomites (primarily wool and hides) No person-to-person transmission of inhalation anthrax

Pathogenesis

Clinical syndromes
Cutaneous anthrax:
Most common, Inoculation of spores under skin. Gelatinous edema at the site Papule vesicle Ulcer pustule (malignant pustule) necrotic ulcer (painless). Painless ulcer (eschar) with a characteristic black necrotic center Dissemination Septicemia shock and death Inhalation Of Spore Or Bioterrorism Gradual Onset (1-6 Days) Fever, Non-productive Cough, Muscle Pain, Malaise, Dyspnea, Diaphoresis, Stridor, Cyanosis. Severe Hilar Lymph Node Necrosis And Mediastinal Hemorrhage X-ray Mediastinal Widening Shock, And Death Usually Occur Within 24-36 H After The Onset Of Respiratory Distress

Pulmonary Anthrax:

Courtesy by AIMS India.

Courtesy by Dr.Alvin fox.

Gastrointestinal Anthrax:
Rare
Ingestion Of Poorly Cooked Meat From Infected Animals Necrosis And Hemorrhage, Abdominal Pain, Vomiting And Bloody Diarrhea High Mortality Rate

Meningitis

Diagnosis
Non-hemolytic, Non-pigmented Colonies - Irregular Borders "Medusa Head" Or "Comet Tail". Show Large Gram Positive Bacilli In Long Chains "Bamboo-like Appearance or Box car The Capsule Can Be Visualized Microscopically Using India Ink.

Treatment & Prevention

Penicillin, Tetracycline And Fluoroquinolones

Vaccination To Susceptible Individuals

Bacillus cereus
Motile Non-encapsulated Obligate pathogen Spore former Hemolytic organism Contaminated food (primarily rice)

Colonies of Bacillus cereus on the left; colonies of Bacillus anthracis on the right. B. cereus colonies are larger, more mucoid, and this strain exhibits a slight zone of hemolysis on blood agar. Courtesy by Dr.Kenneth Toder

Virulent Factors
Spore Formation

Toxins : Emetic Toxin & Enterotoxin (3 types)

Emetic Toxin Vomiting And Nausea Enterotoxins :
1. Hemolytic (HbL): Hemolytic, Cytotoxic, Dermonecrotic, And Vascular Permeability Activities

2.
3.

Non Hemolytic (Nhe): Enterotoxin And Cytotoxic Activity

Cytotoxin (EntK): Similar To The -toxin Of Clostridium Perfringens

Clinical features
Two types Emetic (commonly found in rice)
Nausea, vomiting, abdominal cramps Self limiting recovery within 24 hours Incubation period 1-5 hours

Diarrheal
Incubation period 1-24 hours

Profuse diarrhea with abdominal pain and cramps

Fever and vomiting uncommon

Diagnosis & Treatment

Fecal and Food samples Symptomatic, normally resolves in 24 hrs.