Clostridium Botulinum

Question 1

Definition of clostridium botulinum

Answer 1

commonly grows in soil and produces a toxin that leads to acute paralytic illness

Question 2

3 Types of clostridium botulinum

Answer 2

Foodborne (25%), Infant (72%), Wound

Question 3

Incidence of clostridium botulinum

Answer 3

About 110 cases/yr in USA

Question 4

Incubation Period of clostridium botulinum

Answer 4

Variable; 6 HOURS - 10 DAYS (typically 18-36 hrs)

Question 5

Presentation in Adults of clostridium botulinum

Answer 5

“Descending Paralysis,” droopy eyelids, blurred vision, slurred speech, difficulty swallowing, fixed/dilated pupils, can even paralyze respiratory muscles and extremeties

Question 6

Presentation in Infants of clostridium botulinum

Answer 6

“Floppy Infant”: lethargic, feed poorly, constipated, poor muscle tone, weak cry

Question 7

Is clostridium botulinum Reportable in NC?

Answer 7

Yes- IMMEDIATELY

Question 8

Differential of clostridium botulinum

Answer 8

1. Guillian Barre (often autoimmune)
2. stroke
3. Myasthenia Gravis (use tests for nerve conduction, spinal fluid analysis, tensilon test)

Question 9

How to confirm patient has botulism?

Answer 9

Inject clinical serum, stool, or wound specimen into mouse- look for signs of botulism in mouse/isolate botulism from the stool
must be done at state department

Question 10

Treatment

Answer 10

supportive care: ventilator if needed!
Adults: antitoxin
Infants: immune globulin (passive immunity)

Question 11

Prevention

Answer 11

1. follow food safety guidelines when home canning
2. don’t give honey to infants under 12 months
3. avoid drug injection