Botulism overview: Difference between revisions
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==Overview== | ==Overview== | ||
Botulism ([[Latin]], botulus, sausage) is a rare, but serious [[paralytic]] illness caused by a nerve [[toxin]], [[botulin]], that is produced by the bacterium ''[[Clostridium botulinum]]''. Botulinic toxin is one of the most powerful known toxins: about one microgram is lethal to humans. It acts by blocking [[nerve]] function and leads to [[respiratory system|respiratory]] and [[musculoskeletal]] [[paralysis]]. | |||
==Causes== | ==Causes== | ||
Revision as of 18:28, 26 February 2013
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Botulism Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.
Overview
Botulism (Latin, botulus, sausage) is a rare, but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. Botulinic toxin is one of the most powerful known toxins: about one microgram is lethal to humans. It acts by blocking nerve function and leads to respiratory and musculoskeletal paralysis.
Causes
Clostridium botulinum is found in soil and untreated water throughout the world. It produces spores that survive in improperly preserved or canned food, where they produce toxin. When eaten, even tiny amounts of this toxin can lead to severe poisoning. The foods most commonly contaminated are home-canned vegetables, cured pork and ham, smoked or raw fish, and honey or corn syrup. Botulism may also occur if the organism enters open wounds and produces toxin there. Infant botulism occurs when living bacteria or its spores are eaten and grow within the baby's gastrointestinal tract. The most common cause of infant botulism is eating honey or corn syrup. Clostridium botulinum also occurs normally in the stool of some infants.
It has also been speculated that it is possible to acquire botulism through inhalation. So far, the only human cases of this occurring have been due to factory workers inadvertently inhaling it. It has been suspected that the botulinum toxin could be aerosolized into a weapon for use in a bioterrorist attack.
Risk Factors
Infants are especially vulnerable to botulism. Utilizing canned foods also increases the risk for contracting botulism.
Diagnosis
Laboratory Findings
Clinical diagnosis of botulism is confirmed by specialized laboratory testing that often requires days to complete. Routine laboratory test results are usually unremarkable. Therefore, clinical diagnosis is the foundation for early recognition of and response to a bioterrorist attack with botulinum toxin, and all treatment and management decisions should be made based on clinical diagnosis.
CT
Normal CTs and MRIs help to rule out CVA.
MRI
Normal CTs and MRIs help to rule out CVA.
Other Diagnostic Studies
A normal Tensilon test helps to differentiate botulism from myasthenia gravis; borderline positive tests can occur in botulism.
Treatment
Medical Therapy
Clostridium botulinum is a toxin that paralyzes the muscles. Breathing requires the use of many muscles, inluding the diaphragm. Therefore, botulism will make breathing very difficult and interventions to aid in the breathing process will be essential. Many people with botulism will need to be on a mechanical ventilator for a significant period of time. There are also other therapies such as antitoxin treatment. This method is not readily used on infants because of adverse side effects.
Secondary Prevention
After someone has been exposed to the clostridium botulinum bacteria, there needs to be ways to stop it from spreading and eventually causing damage to the host. This can be done through different techniques such as administering antitoxin and decontaminating suspected food sources.
Cost-Effectiveness of Therapy
Since there are only a few major treatments for Botulism, the financial aspect of the treatment will be relatively straight forward. The financial costs will revolve around things such as a prolonged hospital stay as well as antitoxin therapy. It should also be noted that cosmetic Botox will be at a different cost.
Future or Investigational Therapies
Classically, the treatment for botulism has been to deliver an antitoxin to the patient once exposed. Also, putting the patient on a mechanical ventilator has been a successful treatment method because patients with botulism have extreme trouble breathing on their own. Even though these treatments have been successful, there have been tests on a new drug that will block potassium channels in order to restore neuromuscular function after botulinum intoxication.