MIcrobial toxin

Systemic

• TSST (Toxic-shock syndrome) -- S. aureus
• Toxic shock-like syndrome -- S. pyogenes (Scarlet fever)
• Alpha toxin -- Gas gangrene
• Shiga toxin / shiga-like
• Ribosome inactivation
• Cytokine release -> HUS
• N-dotoxin = gram-Negative (especially -- Lipid A)
• Macrophage -- fever, necrosis, shock
• IL-1 -- Fever
• TNF -- necrosis
• NO -- shock
• Complement -- edema (C3a), neutrophil chemotaxis (C5a)
• Hageman factor -- coagulation -> DIC

Local

• Pseudomembrane
• Coynebacterium diphtheriae / Pseudomonas exotoxin A: EF-2 inactivation
• GI
• ADP ribosylating A-B toxin
• Labile like the Air, Stable like the Ground
• Heat labile -- cAMP inducer of -- ETEC
• Vibrio cholerae: adenylyl cyclase = Cl pump (decreased Na absorption)
• Bordetella pertussis
• Increased cAMP -> Whooping cough (cAMP inducer)
• Chemokine receptor -> lymphocytosis
• Neurotoxin
• Tetanospasmin
• Botox
• Bacillus anthracis -- edema factor = adenylyl cyclase (cAMP inducer)

Systems

• Skin, connective tissue
• CVS
• RS
• GI, hepatobiliary
• KUB
• Reproductive
• Musculoskeletal
• Nervous system
• Lymphatic system, immune system

Anatomic

• HEENT
• Chest
• Abdomen
• Pelvic
• Extremities