Exotoxin Health Dictionary

Exotoxin: From 4 Different Sources


A poison released by certain types of bacteria that enters the bloodstream and causes widespread effects around the body. Exotoxins are among the most poisonous substances known. Infections by tetanus, diphtheria, and some other bacteria that release lifethreatening exotoxins can be prevented by immunization. Treatment of such infections usually includes administration of antibiotic drugs and an antitoxin. (See also endotoxin; enterotoxin.)
Health Source: BMA Medical Dictionary
Author: The British Medical Association
A powerful poison produced by a bacterial cell and secreted into its surrounding environment. Exotoxins are often damaging to only few tissues and they are usually inactivated by chemicals, heat and light. Bacteria causing BOTULISM, DIPHTHERIA and TETANUS all produce exotoxins. (See ENDOTOXIN.)
Health Source: Dictionary of Tropical Medicine
Author: Health Dictionary
A toxin secreted by certain bacterial species or strains into the surrounding medium during growth. Often cause clinical features very specific to the disease (eg tetanus, diphtheria, cholera). Exotoxins secreted by enteric organisms often termed ‘enterotoxins’.
Health Source: Medical Dictionary
Author: Health Dictionary
n. a highly potent poison, often harmful to only a limited range of tissues, that is produced by a bacterial cell and secreted into its surrounding medium. It is generally unstable, being rendered inactive by heat, light, and chemicals. Exotoxins are produced by such bacteria as those causing *botulism, *diphtheria, and *tetanus. Compare endotoxin.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Bacteria

(Singular: bacterium.) Simple, single-celled, primitive organisms which are widely distributed throughout the world in air, water, soil, plants and animals including humans. Many are bene?cial to the environment and other living organisms, but some cause harm to their hosts and can be lethal.

Bacteria are classi?ed according to their shape: BACILLUS (rod-like), coccus (spherical – see COCCI), SPIROCHAETE (corkscrew and spiral-shaped), VIBRIO (comma-shaped), and pleomorphic (variable shapes). Some are mobile, possessing slender hairs (?agellae) on the surfaces. As well as having characteristic shapes, the arrangement of the organisms is signi?cant: some occur in chains (streptococci) and some in pairs (see DIPLOCOCCUS), while a few have a ?lamentous grouping. The size of bacteria ranges from around 0.2 to 5 µm and the smallest (MYCOPLASMA) are roughly the same size as the largest viruses (poxviruses – see VIRUS). They are the smallest organisms capable of existing outside their hosts. The longest, rod-shaped bacilli are slightly smaller than the human erythrocyte blood cell (7 µm).

Bacterial cells are surrounded by an outer capsule within which lie the cell wall and plasma membrane; cytoplasm ?lls much of the interior and this contains genetic nucleoid structures containing DNA, mesosomes (invaginations of the cell wall) and ribosomes, containing RNA and proteins. (See illustration.)

Reproduction is usually asexual, each cell dividing into two, these two into four, and so on. In favourable conditions reproduction can be very rapid, with one bacterium multiplying to 250,000 within six hours. This means that bacteria can change their characteristics by evolution relatively quickly, and many bacteria, including Mycobacterium tuberculosis and Staphylococcus aureus, have developed resistance to successive generations of antibiotics produced by man. (METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)) is a serious hazard in some hospitals.

Bacteria may live as single organisms or congregate in colonies. In arduous conditions some bacteria can convert to an inert, cystic state, remaining in their resting form until the environment becomes more favourable. Bacteria have recently been discovered in an inert state in ice estimated to have been formed 250 million years ago.

Bacteria were ?rst discovered by Antonj van Leewenhoek in the 17th century, but it was not until the middle of the 19th century that Louis Pasteur, the famous French scientist, identi?ed bacteria as the cause of many diseases. Some act as harmful PATHOGENS as soon as they enter a host; others may have a neutral or benign e?ect on the host unless the host’s natural immune defence system is damaged (see IMMUNOLOGY) so that it becomes vulnerable to any previously well-behaved parasites. Various benign bacteria that permanently reside in the human body are called normal ?ora and are found at certain sites, especially the SKIN, OROPHARYNX, COLON and VAGINA. The body’s internal organs are usually sterile, as are the blood and cerebrospinal ?uid.

Bacteria are responsible for many human diseases ranging from the relatively minor – for example, a boil or infected ?nger – to the potentially lethal such as CHOLERA, PLAGUE or TUBERCULOSIS. Infectious bacteria enter the body through broken skin or by its ori?ces: by nose and mouth into the lungs or intestinal tract; by the URETHRA into the URINARY TRACT and KIDNEYS; by the vagina into the UTERUS and FALLOPIAN TUBES. Harmful bacteria then cause disease by producing poisonous endotoxins or exotoxins, and by provoking INFLAMMATION in the tissues – for example, abscess or cellulitis. Many, but not all, bacterial infections are communicable – namely, spread from host to host. For example, tuberculosis is spread by airborne droplets, produced by coughing.

Infections caused by bacteria are commonly treated with antibiotics, which were widely introduced in the 1950s. However, the con?ict between science and harmful bacteria remains unresolved, with the overuse and misuse of antibiotics in medicine, veterinary medicine and the animal food industry contributing to the evolution of bacteria that are resistant to antibiotics. (See also MICROBIOLOGY.)... bacteria

Endotoxin

A poison produced by certain gram-negative bacteria that is released after the microorganisms die. Endotoxins can cause fever and shock, the latter by rendering the walls of blood vessels permeable so that ?uid leaks into the tissues, with a consequent sharp fall in blood pressure. (See EXOTOXIN.)... endotoxin

Streptococcus

Streptococcus is a variety of gram-positive bacterium (see GRAM’S STAIN; BACTERIA) which under the microscope has much the appearance of a string of beads. Most species are saprophytic (see SAPROPHYTE); a few are PATHOGENIC and these include haemolytic types which can destroy red blood cells in a culture of blood agar. This o?ers a method of classifying the varying streptococcal strains. Alphahaeomolytic streptococci are usually associated with bacterial ENDOCARDITIS. SCARLET FEVER is caused by a ?-haeomolytic streptococcus called S. pyogenes. S. pneumoniae, also called PNEUMOCOCCUS, causes respiratory-tract infections, including PNEUMONIA. S. pyogenes may on its own, or with other bacteria, cause severe NECROTISING FASCIITIS or CELLULITIS in which oedema and death of subcutaneous tissues occur. The infection can spread very rapidly and, unless urgently treated with ANTIBIOTICS and sometimes surgery, death may quickly result. This spread is related to the ability of S. pyogenes to produce toxic substances called exotoxins. Although drug-resistant forms are occurring, streptococcal infections usually respond to treatment with antibiotics.... streptococcus

Bacillus Cereus

A Gram positive saprophytic rod which grows on parboiled unrefrigerated rice and other food. It produces potent exotoxins which can cause food poisoning – especially in Chinese and other restaurants specialising in rice dishes. Food poisoning from this organism can cause an emetic syndrome (associated with vomiting) or a diarrhoeal syndrome.... bacillus cereus

Botulism

A rare type of food poisoning with a mortality greater than 50 per cent, caused by the presence of the exotoxin of the anaerobic bacterium Clostridium botulinum, usually in contaminated tinned or bottled food. Symptoms develop a few hours after ingestion.

The toxin has two components, one having haemagglutinin activity and the other neurotoxic activity which produces most of the symptoms. It has a lethal dose of as little as 1 mg/kg and is highly selective for cholinergic nerves. Thus the symptoms are those of autonomic parasympathetic blockade (dry mouth, constipation, urinary retention, mydriasis, blurred vision) and progress to blockade of somatic cholinergic transmission (muscle weakness). Death results from respiratory muscle paralysis. Treatment consists of supportive measures and 4 aminopyridine and 3, 4 di-aminopyridine, which may antagonise the e?ect of the toxin.... botulism

Diphtheria

Disease caused by the exotoxin released by toxigenic strains of Corynebaterium diphtheriae. Maypresent as cutaneous diphtheria (veld sore), nasal diphtheria, or the more severe pharyngeal or laryngeal diphtheria.... diphtheria

Necrotising Fasciitis

Also known as CELLULITIS. A potentially lethal infection caused by the gram-positive (see GRAM’S STAIN) bacterium Streptococcus pyogenes which has the property of producing dangerous exotoxins. The infection, which starts in the layer of FASCIA under the SKIN, may spread very rapidly, destroying tissue as it spreads. Urgent antibiotic treatment may check the infection, and surgery is sometimes required, but even with treatment patients may die (see STREPTOCOCCUS).... necrotising fasciitis

Enterotoxin

A type of toxin released by certain bacteria that inflames the intestinal lining, leading to diarrhoea and vomiting. Enterotoxins cause the symptoms of staphylococcal food poisoning (see staphylococcal infections) and cholera. (See also endotoxin; exotoxin.)... enterotoxin

Microbiology

The study of all aspects of micro-organisms (microbes) – that is, organisms which individually are generally too small to be visible other than by microscopy. The term is applicable to viruses (see VIRUS), BACTERIA, and microscopic forms of fungi, algae, and PROTOZOA.

Among the smallest and simplest microorganisms are the viruses. First described as ?lterable agents, and ranging in size from 20–30 nm to 300 nm, they may be directly visualised only by electron microscopy. They consist of a core of deoxyribonucleic or ribonucleic acid (DNA or RNA) within a protective protein coat, or capsid, whose subunits confer a geometric symmetry. Thus viruses are usually cubical (icosahedral) or helical; the larger viruses (pox-, herpes-, myxo-viruses) may also have an outer envelope. Their minimal structure dictates that viruses are all obligate parasites, relying on living cells to provide essential components for their replication. Apart from animal and plant cells, viruses may infect and replicate in bacteria (bacteriophages) or fungi (mycophages), which are damaged in the process.

Bacteria are larger (0·01–5,000 µm) and more complex. They have a subcellular organisation which generally includes DNA and RNA, a cell membrane, organelles such as ribosomes, and a complex and chemically variable cell envelope – but, unlike EUKARYOTES, no nucleus. Rickettsiae, chlamydia, and mycoplasmas, once thought of as viruses because of their small size and absence of a cell wall (mycoplasma) or major wall component (chlamydia), are now acknowledged as bacteria; rickettsiae and chlamydia are intracellular parasites of medical importance. Bacteria may also possess additional surface structures, such as capsules and organs of locomotion (?agella) and attachment (?mbriae and stalks). Individual bacterial cells may be spheres (cocci); straight (bacilli), curved (vibrio), or ?exuous (spirilla) rods; or oval cells (coccobacilli). On examination by light microscopy, bacteria may be visible in characteristic con?gurations (as pairs of cocci [diplococci], or chains [streptococci], or clusters); actinomycete bacteria grow as ?laments with externally produced spores. Bacteria grow essentially by increasing in cell size and dividing by ?ssion, a process which in ideal laboratory conditions some bacteria may achieve about once every 20 minutes. Under natural conditions, growth is usually much slower.

Eukaryotic micro-organisms comprise fungi, algae, and protozoa. These organisms are larger, and they have in common a well-developed internal compartmentation into subcellular organelles; they also have a nucleus. Algae additionally have chloroplasts, which contain photosynthetic pigments; fungi lack chloroplasts; and protozoa lack both a cell wall and chloroplasts but may have a contractile vacuole to regulate water uptake and, in some, structures for capturing and ingesting food. Fungi grow either as discrete cells (yeasts), multiplying by budding, ?ssion, or conjugation, or as thin ?laments (hyphae) which bear spores, although some may show both morphological forms during their life-cycle. Algae and protozoa generally grow as individual cells or colonies of individuals and multiply by ?ssion.

Micro-organisms of medical importance include representatives of the ?ve major microbial groups that obtain their essential nutrients at the expense of their hosts. Many bacteria and most fungi, however, are saprophytes (see SAPROPHYTE), being major contributors to the natural cycling of carbon in the environment and to biodeterioration; others are of ecological and economic importance because of the diseases they cause in agricultural or horticultural crops or because of their bene?cial relationships with higher organisms. Additionally, they may be of industrial or biotechnological importance. Fungal diseases of humans tend to be most important in tropical environments and in immuno-compromised subjects.

Pathogenic (that is, disease-causing) microorganisms have special characteristics, or virulence factors, that enable them to colonise their hosts and overcome or evade physical, biochemical, and immunological host defences. For example, the presence of capsules, as in the bacteria that cause anthrax (Bacillus anthracis), one form of pneumonia (Streptococcus pneumoniae), scarlet fever (S. pyogenes), bacterial meningitis (Neisseria meningitidis, Haemophilus in?uenzae) is directly related to the ability to cause disease because of their antiphagocytic properties. Fimbriae are related to virulence, enabling tissue attachment – for example, in gonorrhoea (N. gonorrhoeae) and cholera (Vibrio cholerae). Many bacteria excrete extracellular virulence factors; these include enzymes and other agents that impair the host’s physiological and immunological functions. Some bacteria produce powerful toxins (excreted exotoxins or endogenous endotoxins), which may cause local tissue destruction and allow colonisation by the pathogen or whose speci?c action may explain the disease mechanism. In Staphylococcus aureus, exfoliative toxin produces the staphylococcal scalded-skin syndrome, TSS toxin-1 toxic-shock syndrome, and enterotoxin food poisoning. The pertussis exotoxin of Bordetella pertussis, the cause of whooping cough, blocks immunological defences and mediates attachment to tracheal cells, and the exotoxin produced by Corynebacterium diphtheriae causes local damage resulting in a pronounced exudate in the trachea.

Viruses cause disease by cellular destruction arising from their intracellular parasitic existence. Attachment to particular cells is often mediated by speci?c viral surface proteins; mechanisms for evading immunological defences include latency, change in viral antigenic structure, or incapacitation of the immune system – for example, destruction of CD 4 lymphocytes by the human immunode?ciency virus.... microbiology

Corynebacterium

n. a genus of Gram-positive, mostly aerobic, nonmotile rodlike bacteria that frequently bear club-shaped swellings. Many species cause disease in humans, domestic animals, birds, and plants; some are found in dairy products. The species C. diphtheriae (Klebs–Loeffler bacillus) is the causative organism of *diphtheria, producing a powerful *exotoxin that is harmful to heart and nerve tissue. It occurs in one of three forms: gravis, intermedius, and mitis.... corynebacterium

Leukocidin

n. a bacterial *exotoxin that selectively destroys white blood cells (leucocytes).... leukocidin

Staphylococcus

n. a genus of Gram-positive nonmotile spherical bacteria occurring in grapelike clusters. Some species are saprophytes; others parasites. Many species produce *exotoxins. The species S. aureus is commonly present on skin and mucous membranes; it causes boils and internal abscesses. More serious infections caused by staphylococci include pneumonia, bacteraemia, osteomyelitis, and enterocolitis. See also MRSA. —staphylococcal adj.... staphylococcus

Toxic Shock Syndrome

An uncommon, severe illness caused by a toxin produced by the bacterium STAPHYLOCOCCUS AUREUS. Many cases occur in women using vaginal tampons. Other cases have been linked to use of a contraceptive cap, diaphragm, or sponge (see contraception), or to skin wounds or infections by the bacterium elsewhere in the body.A high fever, vomiting, diarrhoea, headache, muscle aches and pains, dizziness, and disorientation develop suddenly. A widespread skin rash that resembles sunburn and also affects the palms and soles, develops. Blood pressure may fall dangerously low, and shock may develop. Other complications include kidney failure and liver failure. Treatment in an intensive care unit may be needed. toxin A poisonous protein produced by pathogenic (disease-causing) bacteria, various animals, or some plants. Bacterial toxins are sometimes subdivided into 3 categories: endotoxins, which are released from dead bacteria; exotoxins, which are released from live bacteria; and enterotoxins, which inflame the intestine.

(See also poison; poisoning; toxaemia.)... toxic shock syndrome

Clostridium

n. a genus of mostly Gram-positive anaerobic spore-forming rodlike bacteria commonly found in soil and in the intestinal tract of humans and animals. Many species cause disease and produce extremely potent *exotoxins. C. botulinum grows freely in badly preserved canned foods, producing a toxin causing serious food poisoning (*botulism); an extremely dilute form of this toxin is now used to treat muscle spasm (see botulinum toxin). C. histolyticum, C. oedematiens, and C. septicum all cause *gas gangrene when they infect wounds. C. tetani lives as a harmless *commensal in the intestine but causes *tetanus on contamination of wounds (with manured soil). The species C. perfringens – Welch’s bacillus – causes blood poisoning, *food poisoning, and gas gangrene. Overgrowth of Clostridium difficile (often shortened to C. diff), a normal inhabitant of the human large intestine, is not uncommon as a complication of some antibiotic therapy and produces a specific condition – pseudomembranous colitis (see pseudomembrane) – which is life-threatening unless treated promptly and is becoming more common as a hospital-acquired infection.... clostridium

Streptolysin

n. an *exotoxin that is produced by strains of Streptococcus bacteria and destroys red blood cells.... streptolysin

Toxin

n. a poison produced by a living organism, especially by a bacterium (see endotoxin; exotoxin). In the body toxins act as *antigens, and special *antibodies (antitoxins) are formed to neutralize their effects.... toxin



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