Medical history (history of illness) represents an important component in the diagnosis of botulism. Family history What is the general health of your family members? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). What symptoms have you noticed? How long has this symptomatology been present? Have you noticed any changes in vision? … Botulism: Medical History
Infectious and parasitic diseases (A00-B99). Poliomyelitis (polio). Tetanus (tetanus) Rabies Psyche – nervous system (F00-F99; G00-G99) Encephalitis (inflammation of the brain). Injuries, poisonings, and other sequelae of external causes (S00-T98). Intoxications (poisonings), unspecified.
The following are the most important diseases or complications that may be contributed to by botulism: Death due to respiratory paralysis Prolonged convalescence (months to years).
A comprehensive clinical examination is the basis for selecting further diagnostic steps General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and eyes [ptosis/pending of the upper eyelid]. Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? … Botulism: Examination
1st order laboratory parameters – obligatory laboratory tests. Toxin detection* from vomit or food residues, blood serum, stool; also in food samples Caution! In infant botulism, toxin detection rarely succeeds! Bacteriological examinations* (often too late) – only in infant botulism or wound botulism (in other cases only toxin effect). * Reportable in the sense of … Botulism: Test and Diagnosis
Therapeutic target Avoidance of complications Therapy recommendations Elimination of the toxin by antitoxin (trivalent antitoxin against types A, B, and E; after type determination, administration of a monovalent toxin if necessary). For food poisoning antitoxin and symptomatic therapy. For wound botulism, surgical wound care and an administration of penicillin In infantile botulism, no antitoxin administration, … Botulism: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal sonography (ultrasound examination of abdominal organs) – for basic diagnostics. Computed tomography/magnetic resonance imaging of the skull (cranial CT or.cCT/cranial MRI or cMRI) – to exclude structural brain … Botulism: Diagnostic Tests
For wound botulism: 1st order Surgical sanitation of wounds (due toanaerobic conditions in deep wounds).
To prevent botulism, attention must be paid to reducing risk factors. Behavioral risk factors Consumption of Contaminated canned foods* , especially canned sausages and vegetables (e.g., beans) – these do not necessarily have to exhibit gas formation and/or an altered odor/taste Roach* * (Rutilus rutilus; synonyms: roach, loggerhead or the swallow): fish from the carp … Botulism: Prevention
The following symptoms and complaints may indicate botulism: Symptoms (by time of onset). Nausea (nausea)/vomiting, diarrhea (diarrhea), constipation (constipation). Blurred vision, diplopia (double vision, double images), photophobia (photophobia). Decreasing saliva and sweat secretion. Difficulty speaking Dysphagia (swallowing disorder) Circulatory disorders Paralysis symptoms of arms / legs Ileus (intestinal obstruction) Respiratory paralysis Symptoms of infant botulism … Botulism: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Botulism is caused by botulinum toxin, which is produced by the bacterium Clostridium botulinum (very rarely also C. butyricum or C. baratii). Botulinum toxin is a toxin that acts on the motor endplate to inhibit muscle excitation. Etiology (Causes) Behavioral causes Consumption of Contaminated canned food, especially canned sausage and vegetables. … Botulism: Causes
General measures Symptomatic therapy with intensive medical monitoring Gastric lavage to remove unabsorbed toxin
