Botulism

Botulism is a serious clinical disease caused by neurotoxins of the bacteria Clostridium botulinum. Botulism comes in three different forms:

Infant botulism is the most common form of botulism that happens when the clostridium spores develop inside the intestinal tract of the baby between 2 to 6 months of age;

Food bourne botulism comes from canned foods where the bacteria thrive in closed spaces with few oxygen;

Wound botulism is when a clostridium bacteria grows and produce toxins inside a wound and develops a dangerous infection.

Botulism Signs and Symptoms

Signs and symptoms of botulism vary from each form. The diagnosis of botulism is primarily based on a good history taking skills of the physician following a Q and A session and evaluation. Toxicology studies of vomit, blood and stools will reveal the botulinum toxins.

Treatment Options

The following treatment options may be available for Clostridium botulinum infections.

Antitoxin – Botulism in its early stage can be treated with antitoxin which may be injected to the body. Antitoxin attaches to the toxins and prevents them from damaging the nerves.

Digestive Purging – For cases of food bourn botulism, physician may induce people infected to vomit gastric contents to get rid of the toxins. They may be given medications that induce bowel movement to eliminate toxins in the intestine.

Surgical – People with wound botulism may require surgical debridement or the surgical removal of the infective tissues from the wound. Hyperbaric oxygen may be introduced directly to the wound to eliminate the anaerobic clostridium bacteria and spores.

Ventilator – For those paralyzed with the toxins that exhibit difficulty in breathing, mechanical ventilators may aid breathing for weeks to months until full recovery.  

Outcome

Untreated cases of botulism are potentially fatal, thus emergency care should be considered promptly after diagnosis. Infant botulism has no long term side effects with a very minimal case fatality rating of 1%. The general mortality rate of wound botulism is only 10% as of 1990 while food bourn botulism in all ages is 7.5%. Deaths associated with respiratory paralysis dropped down to 2% due to improved artificial respirators beyond 1990.

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