Gram-positve
bacilli capable of forming endospores (see WebLinked
image)
Naturally
occuring in environment: soil, water, vegetation, intestinal tract of mammals
and birds, fish, insects
Healthy
adults and children can be asymptomatic carriers
Transmitted
to man via direct contact with environmental sources or ingestion of contaminated
food products, including milk, cheese, cole slaw, fish, chicken, beef, pork,
vegetables, etc.
Primarily
infection of neonates and older adults
Three
clinical manifestations dependent on :
Organisms
passed from mother to fetus either:
If
infection occurs during delivery, disease presents in one of two clinical forms:
Facultative
intracellular pathogen that invades and grows in variety of mammalian cells,
including:
Normal
macrophages readily phagocytose extracellular organisms that have been opsonized
with complement or antibody, but these organisms can then survive intracellularly.
Once internalized via phagocytosis, organisms are capable of breaking down phagolysosome
membrane, multiplying in the cytoplasm, and passing directly into a new host
cell, via pseudopod extensions and actin filaments
Antibodies,
i.e., humoral immune response and extracellular bactericidal factors are ineffective
against these organisms
Cell-mediated
immune response dependent on macrophage activation by lymphokines (T cell response)
eventually are effective at clearing organisms
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