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La corne antérieure de la ME est plutôt

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- Enterotoxin A ® chemotactic for neutrophils, stimulating the infiltration of polymorphonuclear neutrophils into the ileum with the release of cytokines also produces a cytopathic effect, resulting in disruption of the tight cell-to-cell junction, increased permeability of the intestinal wall, and subsequent diarrhoea- Cytotoxin B ® causes actin to depolymerise, with the resultant destruction of the cellular cytoskeleton- Adhesion factor- Hyaluronidase- Spore formation- Fecal-oral, uptaking spores- Asymptomatic colonisation- Antibiotic-associated colitis ® acute diarrhoea generally develops 5 to 10 days after initiation of antibiotic treatment (particularly clindamycin, penicillins, cephalosporins, and fluoroquinolones); it may be brief and self-limited or more protracted- Pseudomembranous colitis ® the most severe form of C. difficile infection; profuse diarrhoea, abdominal cramping, and fever; whitish plaques (pseudomembranes) over intact colonic tissue seen on colonoscopy

- a spiral organism, has variable number (7-11) of endoflagella- Are highly motile.- Stains readily with aniline dyes and by silver impregnation techniques- Cultivation- grows very slowly in a complex liquid media (isolated from ECM skin lesions or ticks) - low diagnostic yield, it is seldom used

- Outer surface proteins: OspA and F- (OspA and OspB in ticks)- The transmission of B.burgdorferi to humans is by injection of the organism in tick saliva or by regurgitation of the tick's midgut contents. Attachment of the tick for 24-48 h is necessary before transmission of B.burgdorferi → B.burgdorferi adheres to proteoglycans on host cells, this is mediated by a borrelial glycosaminoglycan receptor → After injection by the tick, the organism migrates out from the site, producing the characteristic skin lesion → Dissemination occurs by lymphatics or blood to other skin and musculoskeletal sites and many other organs → Lyme disease, like other spirochetal diseases, occurs in stages with early and late manifestations- Lyme disease:1. Erythema chronicum migrans (ECM)a. A unique skin lesion is Erytema chronicum migrans (ECM), which occurs at the tick bite site.2. Neurologic/Cardiologic manifestationa. Occurs weeks to months later and includes arthralgia and arthritis; neurologic manifestations with meningitis; and cardiac disease with conduction defects and myopericarditis.3. Arthritisa. Begins months to years later with chronic skin, nervous system,or joint involvement.

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