Clostridios

Clostridios

Las especies de Clostridia Clostridia Clostridia species comprise a group of spore-forming, obligate anaerobic, gram-positive bacilli. Major pathogenic species include Clostridium perfringens (C. perfringens), which is associated with gas gangrene; Clostridioides difficile, which is associated with pseudomembranous colitis; C. tetani, which causes tetanus; and C. botulinum, which causes botulism. Clostridia comprenden un grupo de bacilos gram-positivos, anaerobios obligados, formadores de esporas. Las principales especies patógenas incluyen Clostridium perfringens Clostridium perfringens The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. Gas Gangrene ( C. perfringens C. perfringens The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. Gas Gangrene), que se asocia con gangrena gaseosa; Clostridioides difficile, que se asocia con colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis pseudomembranosa; C. tetani C. tetani The cause of tetanus in humans and domestic animals. It is a common inhabitant of human and horse intestines as well as soil. Two components make up its potent exotoxin activity, a neurotoxin and a hemolytic toxin. Clostridia, que causa el tétanos; y C. botulinum C. botulinum A species of anaerobic, gram-positive, rod-shaped bacteria in the family clostridiaceae that produces proteins with characteristic neurotoxicity. It is the etiologic agent of botulism in humans, wild fowl, horses; and cattle. Seven subtypes (sometimes called antigenic types, or strains) exist, each producing a different botulinum toxin (botulinum toxins). The organism and its spores are widely distributed in nature. Clostridia, que causa el botulismo. Clostridium perfringens Clostridium perfringens The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. Gas Gangrene ( C. perfringens C. perfringens The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. Gas Gangrene), Clostridioides difficile, C. tetani C. tetani The cause of tetanus in humans and domestic animals. It is a common inhabitant of human and horse intestines as well as soil. Two components make up its potent exotoxin activity, a neurotoxin and a hemolytic toxin. Clostridia, y C. botulinum C. botulinum A species of anaerobic, gram-positive, rod-shaped bacteria in the family clostridiaceae that produces proteins with characteristic neurotoxicity. It is the etiologic agent of botulism in humans, wild fowl, horses; and cattle. Seven subtypes (sometimes called antigenic types, or strains) exist, each producing a different botulinum toxin (botulinum toxins). The organism and its spores are widely distributed in nature. Clostridia tienen una invasividad de amplio espectro y manifestaciones clínicas que se resumen a continuación. Tenga en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cuenta que Clostridium difficile Clostridium difficile A common inhabitant of the colon flora in human infants and sometimes in adults. The type species clostridioides difficile is formerly known as Clostridium difficile. It is a causative agent for clostridioides infections and is associated with pseudomembranous enterocolitis in patients receiving antibiotic therapy. Clostridia ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia sido reclasificado como Clostridioides difficile. Sin embargo, es probable que los LOS Neisseria exámenes no tengan el género actualizado durante varios años.

Last updated: Jan 16, 2024

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Contents

Clasificación

Características Generales

Clostridium botulinum

Clostridium (Clostridioides) difficile

Clostridium perfringens

Clostridium tetani

Referencias

Clasificación

Características Generales

Características básicas de las especies de Clostridium

Bacilos gram-positivos
Organismos formadores de esporas
Anaerobios obligados
Hábitat:
- Suelo, agua dulce, sedimentos marinos
- Tracto intestinal de humanos y animales
- Flora cérvico-vaginal
- Las esporas pueden estar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el aire.
Patogénesis:
- La infección puede ser exógena (del exterior) o endógena.
- Causan enfermedad por exotoxinas o producción de enterotoxinas

Dibujos animados de clostridios — Dibujo que muestra la estructura general de la bacteria gram-positiva *Clostridia*
Imagen por Lecturio.

Especies patógenas

C. perfringens C. perfringens The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. Gas Gangrene (20%–40% de todos los LOS Neisseria aislamientos)
Clostridioides difficile
C. tetani C. tetani The cause of tetanus in humans and domestic animals. It is a common inhabitant of human and horse intestines as well as soil. Two components make up its potent exotoxin activity, a neurotoxin and a hemolytic toxin. Clostridia
C. botulinum C. botulinum A species of anaerobic, gram-positive, rod-shaped bacteria in the family clostridiaceae that produces proteins with characteristic neurotoxicity. It is the etiologic agent of botulism in humans, wild fowl, horses; and cattle. Seven subtypes (sometimes called antigenic types, or strains) exist, each producing a different botulinum toxin (botulinum toxins). The organism and its spores are widely distributed in nature. Clostridia

Tabla: Comparación y contraste de especies de Clostridia Clostridia Clostridia species comprise a group of spore-forming, obligate anaerobic, gram-positive bacilli. Major pathogenic species include Clostridium perfringens (C. perfringens), which is associated with gas gangrene; Clostridioides difficile, which is associated with pseudomembranous colitis; C. tetani, which causes tetanus; and C. botulinum, which causes botulism. Clostridia
	C. botulinum C. botulinum A species of anaerobic, gram-positive, rod-shaped bacteria in the family clostridiaceae that produces proteins with characteristic neurotoxicity. It is the etiologic agent of botulism in humans, wild fowl, horses; and cattle. Seven subtypes (sometimes called antigenic types, or strains) exist, each producing a different botulinum toxin (botulinum toxins). The organism and its spores are widely distributed in nature. Clostridia	Clostridioides difficile	C.perfringens	C. tetani C. tetani The cause of tetanus in humans and domestic animals. It is a common inhabitant of human and horse intestines as well as soil. Two components make up its potent exotoxin activity, a neurotoxin and a hemolytic toxin. Clostridia
Hábitat	Tierra Sedimentos marinos	Flora intestinal	Tierra Flora intestinal	Tierra Flora intestinal
Virulencia	Toxina botulínica	Enterotoxina A Toxina B	Toxina alfa Enterotoxina	Toxina tetánica (tetanoespasmina)
Transmisión	Ingestión de: Esporas Toxina preformada	A través de esporas: Infección nosocomial (mal lavado de manos) Flora intestinal oportunista	A través de esporas: Heridas traumáticas Ingestión de alimentos	A través de esporas: Heridas traumáticas Contaminación del cordón umbilical durante el parto
Presentación clínica	Parálisis flácida Botulismo Lactantes: síndrome del bebé flácido	Diarrea nosocomial Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis pseudomembranosa	Intoxicación alimentaria Celulitis localizada Mionecrosis por Clostridium	Parálisis espástica Trismo Risa sardónica Opistótonos Tétanos neonatal

Clostridium botulinum

Epidemiología

Botulismo transmitido por alimentos:
- En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos, es más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria nativos de Alaska (a través de la ingestión de pescado añejo)
- La tasa nacional general es de 0,0068 por 100 000
Botulismo infantil:
- Ingestión de esporas:
  - De miel cruda
  - Del polvo ambiental
- La incidencia más alta se presenta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Utah, Pensilvania y California
Botulismo por heridas: en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum usuarios de drogas inyectables

Transmisión

Los LOS Neisseria adultos ingieren la toxina preformada de los LOS Neisseria alimentos:
- Asociado con un enlatado inadecuado
- A veces de bebidas fermentadas (e.g., alcohol ilegal)
Los LOS Neisseria bebés ingieren las esporas: luego se produce la toxina in vivo
Botulismo por heridas:
- Contaminación de heridas con esporas
- Germinación y producción de toxinas in vivo

Patogénesis

El botulismo es una enfermedad neuroparalítica potencialmente mortal.
Neurotoxina botulínica:
- Proteasa que escinde las proteínas solubles del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de la proteína de unión del factor sensible a la N-etilmaleimida
- Inhibe la liberación de acetilcolina ( ACh ACh A neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. Receptors and Neurotransmitters of the CNS) estimulante
- Provoca depleción de ACh ACh A neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. Receptors and Neurotransmitters of the CNS en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las uniones neuromusculares
- Provoca parálisis flácida

Mecanismo fisiopatológico causado por Clostridium botulinum — Mecanismo fisiopatológico causado por *Clostridium botulinum*
La introducción del patógeno con su toxina provoca hiperexcitación, ya que parte de la toxina impide que la placa motora terminal libere sus neurotransmisores en la sinapsis
Imagen por Lecturio.

Presentación clínica

Adultos:

Síntomas prodrómicos:
- Náuseas/vómitos
- Dolor Dolor Inflammation abdominal
- Diarrea
- Boca seca
- Dolor Dolor Inflammation de garganta
Síntomas iniciales:
- Diplopía
- Ptosis Ptosis Cranial Nerve Palsies
- Disfagia
Parálisis flácida descendente
La gravedad puede variar.

Lactantes (síndrome del bebé flácido):

Hipotonía
Dificultades para la alimentación
Llanto débil
Babeo
Irritabilidad

Lactante de seis semanas con botulismo
Marcada pérdida de tono muscular, especialmente en la región de la cabeza y el cuello
Imagen: “PMC3223485_eplasty11e47_fig5” por Chopra K, Conde-Green A, Folstein MK, Knepp EK, Christy MR and Singh DP. Licencia: CC BY 2.0.

Identificación

Identificación de toxinas a partir de:
- Suero
- Heces
- Vómito
- Comida
Prueba de ensayo inmunoabsorbente ligado a enzimas ( ELISA ELISA An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. St. Louis Encephalitis Virus, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
Bioensayo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ratón
Reacción en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cadena de la polimerasa ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR), por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) cuantitativa: detecta genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure de toxinas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el organismo

Microfotografía de la bacteria *Clostridium botulinum*
Imagen: “Clostridium botulinum” por CDC. Licencia: Dominio Público.

Clostridium (Clostridioides) difficile

Epidemiología

Causa más común de colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis inducida por antibióticos (especialmente asociada con clindamicina)
Prevalencia:
- En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos sanos: 3%
- En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos hospitalizados/institucionalizados: 8%–10%
Las nuevas exposiciones tienen más probabilidades de resultar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una enfermedad sintomática

Transmisión

Transmisión fecal-oral de esporas
Esporas transmitidas de persona a persona (mal lavado de manos)

Patogénesis

Produce 2 potentes exotoxinas
Inactiva las enzimas homólogas de Ras RAS Renal artery stenosis (RAS) is the narrowing of one or both renal arteries, usually caused by atherosclerotic disease or by fibromuscular dysplasia. If the stenosis is severe enough, the stenosis causes decreased renal blood flow, which activates the renin-angiotensin-aldosterone system (RAAS) and leads to renovascular hypertension (RVH). Renal Artery Stenosis (Rho) guanosina trifosfato (GTP):
- Enterotoxina A:
  - Se dirige a las enzimas del borde en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cepillo
  - Altera la secreción de líquidos
  - Causa diarrea acuosa
- Toxina B (10 veces más potente):
  - Despolimeriza la actina
  - Altera el citoesqueleto de los LOS Neisseria enterocitos
  - Causa colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis pseudomembranosa
Ácido dipicolínico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el núcleo de la espora: altamente resistente al AL Amyloidosis calor Calor Inflammation y a los LOS Neisseria productos químicos

Presentación clínica

Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis pseudomembranosa:

Dolor Dolor Inflammation abdominal
Diarrea acuosa profusa (ocasionalmente puede ser sanguinolenta)
Leucocitosis
Asociada con el uso reciente de antibióticos

Muestra patológica que muestra colitis pseudomembranosa
Imagen: “Pseudomembranous colitis” por el patólogo de turno. Licencia: Dominio Público

Identificación

Detección de antígenos tóxicos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum heces
PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR) para el ácido desoxirribonucleico (ADN) de Clostridioides difficile

Clostridium perfringens

Epidemiología

Intoxicación alimentaria:
- 2da causa más común de enfermedades transmitidas por alimentos
- Se estiman 1 millón de casos cada año en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos
Infecciones de tejidos blandos:
- 30%–80% de las heridas abiertas están contaminadas con especies de Clostridium.
- 80% de los LOS Neisseria casos de gangrena gaseosa traumática
- Generalmente, la gangrena gaseosa espontánea es causada por otra especie: C. septicum C. septicum A species of gram-positive bacteria in the family clostridiaceae. Infections have a strong association with malignancies and also with gas gangrene. Gas Gangrene.

Transmisión

Esporas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la tierra: contaminación de heridas
Esporas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum carnes recalentadas: intoxicación alimentaria

Patogénesis

Mionecrosis (gangrena gaseosa):

Toxina alfa:
- Toxina hemolítica; esencial para las manifestaciones de la enfermedad y la mortalidad
- Tiene actividad de fosfolipasa C y esfingomielinasa
- Degrada los LOS Neisseria tejidos y las membranas celulares
- Provoca trombosis de vasos pequeños e isquemia tisular
- La isquemia crea un entorno anaeróbico → mayor propagación de C. perfringens C. perfringens The most common etiologic agent of gas gangrene. It is differentiable into several distinct types based on the distribution of twelve different toxins. Gas Gangrene
- También deprime el gasto cardíaco y contribuye al AL Amyloidosis shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock sistémico
Toxina theta (perfringolisina O):
- Citolisina formadora de poros
- Citotóxica para las células vasculares e inmunitarias
- No es esencial para la mortalidad

Intoxicación alimentaria:

Causada por cepas tipo A
Las esporas sobreviven a las temperaturas de cocción y se propagan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum alimentos almacenados incorrectamente.
Enterotoxina:
- Interrumpe el transporte de iones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el íleon
- Provoca diarrea acuosa

Presentación clínica

Enfermedad transmitida por alimentos:
- Diarrea acuosa de inicio insidioso con cólicos abdominales
- Los LOS Neisseria vómitos y la fiebre son poco comunes.
- 12–24 horas después del consumo de alimentos
- Autolimitada, se resuelve en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 1–3 días
Mionecrosis:
- Dolor Dolor Inflammation severo
- Crepitación tisular (por formación de gas)
- Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema, ampollas y bullas
- Decoloración violácea de la piel
- Fiebre, cambios del estado mental

Gangrena gaseosa de la pierna derecha y la pelvis
Imagen: “Gas gangrene” de Engelbert Schröpfer, Stephan Rauthe and Thomas Meyer. Licencia: CC BY 2.0.

Identificación

Tinción de Gram y cultivo de los LOS Neisseria tejidos/líquido de la ampolla
Hemocultivos
Coprocultivos para la enfermedad transmitida por alimentos
Características distintivas de crecimiento:
- Agar yema de huevo: forma una zona turbia
- Catalasa negativa
- Oxidasa negativa
- Zona de doble hemólisis en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agar sangre
- Inmóvil
- Encapsulado

Clostridium tetani

Epidemiología

Causa tétanos: un trastorno del sistema nervioso
Muy raro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum países ricos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum recursos debido a la vacunación generalizada
Sigue siendo endémica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum países de recursos limitados

Transmisión

A través de esporas
Asociado con heridas punzantes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la piel:
- Clavos oxidados
- Alambre de púas
- Trabajadores de construcción
No crecerá en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum tejidos sanos
Factores predisponentes:
- Isquemia localizada
- Tejido desvitalizado
- Cuerpo extraño
- Coinfección con otras bacterias

Patogénesis

Periodo promedio de incubación: 8 días
Transporte retrógrado de toxina al AL Amyloidosis sistema nervioso central (SNC)
Toxina tetánica o tetanoespasmina (toxina A/B):
- Proteasa que escinde la proteína soluble del receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de la proteína de unión del factor sensible a la N-etilmaleimida
- Bloquea la exocitosis de neurotransmisores inhibitorios (ácido gamma-aminobutírico ( GABA GABA The most common inhibitory neurotransmitter in the central nervous system. Receptors and Neurotransmitters of the CNS, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y glicina) de las células de Renshaw en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la médula espinal
- Provoca la acumulación de ACh ACh A neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. Receptors and Neurotransmitters of the CNS
- Provoca parálisis espástica

Mecanismo fisiopatológico causado por Clostridium tetani — Mecanismo fisiopatológico causado por *Clostridium tetani*
La tetanoespasmina bloquea la unión de los neurotransmisores (GABA/glicina) a sus receptores en la membrana postsináptica; por lo tanto, a la neurotransmisión inhibitoria
Imagen por Lecturio.

Presentación clínica

Generalizada:
- Parálisis espástica
- Risa sardónica
- Trismo
- Opistótono
Local:
- Solo 1 extremidad o parte del cuerpo involucrada
- A menudo progresa a ser generalizada
Cefálica:
- Compromiso predominante de los LOS Neisseria pares craneales
- Puede progresar a ser generalizada
Neonatal:
- Resulta de la contaminación del cordón umbilical en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el momento del parto
- Rara en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria países desarrollados

Risus sardonicus en paciente con tétanos generalizado — Risa sardónica en un paciente con tétanos generalizado
Imagen: “PMC4946959_cureus-0008-000000000644-i01” por Zunga PM, Tarfarosh SF, Farooq O, Dar IH, Rashid S y Yaseen U. Licencia: CC BY 3.0.

Identificación

Crece en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance neutro o alcalino
En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum diferentes medios anaerobios:
- Tioglicolato
- Hidrolizado de caseína
- Agar sangre

Prevención

Vacuna toxoide
Para heridas limpias, administre la vacuna:
- Si < 3 dosis previas
- Si última dosis hace HACE Altitude Sickness > 10 años
Para heridas contaminadas:
- Administre la vacuna si la última dosis fue hace HACE Altitude Sickness > 5 años.
- Administre inmunoglobulina antitetánica humana si < 3 dosis de vacuna toxoide.

Referencias

Bryant, A. E., & Stevens, D. L. (2022). Gas gangrene and other clostridial infections. In J. Loscalzo, A. S. Fauci, D. L. Kasper, S. Hauser, D. Longo, & J. L. Jameson (Eds.), Harrison’s principles of internal medicine (21st ed., Vol. 1-2, Chapter 154). McGraw Hill.
Bring, M. (2023). Botulism. https://www.who.int/news-room/fact-sheets/detail/botulism
Lamont, J. T., Kelly, C. P., & Bakken, J. S. (2025). Clostridioides difficile infection in adults: Clinical manifestations and diagnosis. UpToDate. Retrieved June 26, 2025, from https://www.uptodate.com/contents/clostridioides-difficile-infection-in-adults-clinical-manifestations-and-diagnosis
LaRocque, R., & Harris, J. B. (2025). Causes of acute infectious diarrhea and other foodborne illnesses in resource-abundant settings. UpToDate. Retrieved June 26, 2025, from https://www.uptodate.com/contents/causes-of-acute-infectious-diarrhea-and-other-foodborne-illnesses-in-resource-abundant-settings
Pegram P.S., & Stone S.M. (2025). Botulism. UpToDate. Retrieved June 26, 2025, from https://www.uptodate.com/contents/botulism
Sexton D.J., & Thwaites L. (2025). Tetanus. UpToDate. Retrieved June 26, 2025, from https://www.uptodate.com/contents/tetanus
Stevens D.L, & Bryant A. (2025). Clostridial myonecrosis. UpToDate. Retrieved June 26, 2025, from https://www.uptodate.com/contents/clostridial-myonecrosis

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