Botulism

Botulism

Clostridium Botulinum :  Gram + anaerobic rods, spore formation on exposure to oxygen, undercooked meal, blocks presynaptic terminal’s.

🔴 Neurotoxin : 8 toxins A to G  with 2 types of C1, C2. A is most toxic. 

🔴 Common human disease caused by A,B, E. Rarely F

🔴 once gets into the bloodstream it goes to block the presynaptic terminal of the neuromuscular muscular junction of voluntary motor and autonomic nervous system. 

🔴 symptoms start after 12 to 72 hours of ingestion of contaminated food

🔴 constipation / urinary retention could be due to autonomic nervous system involvement

🔴 avoid magnesium and aminoglycosides

🔴 recovery may take months or even years. 

🔴 S/S : Afebrile, Alert, normal HR & BP, may be bradycardia, lsymmetric motor weakness / flacid paralysis, no sensory deficit, fixed pupils dilated, diplopia, dysarthria, dysphagia, dyspnea, floppy infant syndrom < 1 yr.

Exceptions: secondary fever in infected wound w 10 days incubation period. Food born : incubation 10-36 hrs, nausea, vomiting, diarrhea. Heroin user: black tar Heroin is contaminated.

🔴 Repetitive nerve stimulation at 2 to 5 Hz causes decremental response (reduced > 10% amplitude)

🔴 Heat > 85°C for 5 min will decontaminate

🔴 avoid honey as it contain spores in children < 1 yr

⭕️ Toxin in serum, gastric content, stool, vomit & Food.

✅ Rx: Gastric lavage within hours

♦️Antitoxin rx (A through G) get it from CDC

♦️Supportive care

🔸Cook 120 degrees Celcius for 5-10 minutes

🔸Avoid honey & corn syrup in children < 1 yr of age

🔸Avoid home made canned food / bulging cans/ bad smelling food

♦️Nutritional support / respiratory support

♦️No Magnesium

🔹Antibiotics for wound infection: penicillin and or Metronidazole

♦️Debridement of micro-abscesses

🔸Physical therapy

🔸Occupational therapy

🔸Speech therapy

♦️Dietary eval and rx

👉🏿Talk to CDC

✅ Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) – (Equine):

Total of one vial which is diluted. Starting rate is 0.5 ML per minute for 30 minutes then doubles infusion rate every 30 minutes as tolerated to the maximum infusion is 2 ml per minute.

Call Local health department or CDC 770-488-7100

watching for infusion related side effects.

Max infusion rate: 2 mL/min

Max dose: 1 vial

https://www.cdc.gov/botulism/infant-botulism.html

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2 thoughts on “Botulism”

  1. * descending paralysis
    *black tart heroin is contaminated w spores
    *Micro abscesses in Heroin users should be cleaned and debride and washed
    *food should be warmed 85 deg C = 185 degrees F for > 5 to 10 minutes

    Reply

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