Clostridium botulium- Botulism Flashcards
Case Presentation of Clostridium botulium- Botulism:
- A 25-year-old male presents with complaints of nausea, vomiting and blurred vision of sudden onset. He also complains of weakness and difficulty in swallowing (dysphagia).
- He has no history of episodic weakness. He ate home-canned food the day before.
- PE: No fever, fixed dilated pupils, a decreased gag reflex. Symmetric flaccid paralysis of upper limbs.
- He is admitted to hospital for further monitoring
Common Facts of Cl. Botulinum
•Anaerobic gram positive spore-forming rods *
•Reservoir: soil, aquatic sediments
•Botulinum neurotoxin *
•Forms of Botulism & how they are acquired:
•Forms of Botulism & how they are acquired:
–Foodborne botulism
•Ingestion of preformed toxin
•Home-canned vegetables, * smoked fish
–Infant botulism
•Ingestion of spores *
•Honey *, corn syrup, soil
•Toxin produced in gut
–Wound botulism
- Traumatic implantation of spores (wounds, drug users *)
- Toxin produced invivo
Foodborne botulism:
–Foodborne botulism
- Ingestion of preformed toxin
- Home-canned vegetables, * smoked fish
–Infant botulism is caused by
- Ingestion of spores *
- Honey *, corn syrup, soil
- Toxin produced in gut
–Wound botulism is cause by?
- Traumatic implantation of spores (wounds, drug users *)
- Toxin produced invivo
Foodborne Botulism picture shows?
C. Botulinum- Neurotoxin facts
•A-B polypeptide neurotoxin
–7 types (A to G → A, B, E and F cause disease)
- Coded for by a prophage
- Highly toxic
•Heat labile (destroyed at 60⁰C for 10 minutes) *
•Mechanism of action
–Toxin absorbed by gut → carried by blood to peripheral nerve synapses
–Blocks release of acetylcholine at the myoneuronal junction → flaccid paralysis *
`C. Botulinum- Clinical Disease presentations and facts
•Foodborne botulism
–1-2 days after consuming food (preformed toxin)
–Blurred vision, drooping eyelids, dry mouth, slurred speech *
–Diarrhea/constipation, abdominal pain, No fever
•Infant botulism (“Floppy baby syndrome”)
–Babies are lethargic, feed poorly, weak cry, constipated, poor muscle tone *
•Wound botulism
–Similar symptoms, incubation period is longer, fever present
If untreated these symptoms progress:
–Cause paralysis of respiratory muscles, arms, legs and trunk *
•Recovery:
–May take months to years – until the affected nerve endings regrow
•Early treatment is very important *
Foodborne Botulism:
–1-2 days after consuming food (preformed toxin)
–Blurred vision, drooping eyelids, dry mouth, slurred speech *
–Diarrhea/constipation, abdominal pain, No fever
•Infant botulism (“Floppy baby syndrome”) causes what symptoms and presentation?
–Babies are lethargic, feed poorly, weak cry, constipated, poor muscle tone *
Wound Botulism
•Wound botulism
–Similar symptoms (to infact botulism? double check), incubation period is longer, fever present.
If C. Botulinum is untreated, symptoms progess to
If untreated these symptoms progress:
–to paralysis of respiratory muscles, arms, legs and trunk *
Recovery from C. Botulinum:
Recovery:
–May take months to years – until the affected nerve endings regrow
•Early treatment is very important * to prevent the irreversible binding of toxins to nerves.
C. Botulinum- lab Diagnosis
- Detection of toxin activity in serum*
- Culture of bacteria from stool *
- Isolation from suspected food
