Eight hours after eating reheated meat stew at a canteen, several students develop cramping abdominal pain and watery diarrhoea without vomiting. The causative anaerobe produces a heat-labile enterotoxin that increases permeability by altering tight junction proteins. The responsible organism and its toxin type are:

• A Clostridium perfringens type A, enterotoxin (CPE) ✓
• B Clostridium difficile, toxin A
• C Clostridium botulinum type E, neurotoxin
• D Clostridium septicum, alpha toxin

Explanation

Clostridium perfringens type A food poisoning follows ingestion of spores surviving in reheated meat dishes; the incubation period of 8 to 16 hours with cramps and watery diarrhoea but little vomiting is characteristic. CPE binds epithelial cells and disrupts tight junctions, causing fluid loss. C. difficile toxin A causes antibiotic-associated colitis, botulinum neurotoxin causes paralysis rather than diarrhoea, and C. septicum alpha toxin is associated with spontaneous gas gangrene in neutropenia.

Reference: Jawetz, Melnick and Adelberg's Medical Microbiology, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.