Botulism
Diagnosis
The clinical history and background may influence the diagnosis, but other neurological deficits with engines such as Guillain-Barre syndrome, stroke and myasthenia severe botulism may resemble, and should be excluded by additional tests . These tests may include a brain scan, an examination of the cerebrospinal fluid (CSF), a electroneuromyography (ENMG), and a test Tensilon if we suspected myasthenia serious. The ENMG test is most useful for diagnosis, provided they think make a repetitive stimulation at high frequency which gives a potential increment of the engine picked up on the muscle, a specific block of the neuromuscular junction type pre-synaptic, that is to say, the default release of the acetylcholine in the synapse. This aspect is found only in the myasthenic syndrome of Lambert-Eaton another rare condition that can sometimes cause problems of differential diagnosis.
Definitive diagnosis of botulism can be confirmed by the presence of botulinum toxin in serum or feces of patients whose injection to mice reproduce the signs of the disease. One can also isolate the bacterium in the stool of patients with infant botulism or food, or a sampling of the infected wound in wound botulism.
Treatment of botulism
Respiratory failure in severe cases of botulism requires mechanical ventilation (breathing) for several weeks in intensive care setting. After several weeks, the paralysis slowly improves. If diagnosed early, botulism food or injury can be treated with an antitoxin which blocks the action of toxin circulating in the blood. This condition may prevent patients from worsening, but recovery still takes many weeks. The antitoxin is not used in the treatment of infant botulism.
In cases of foodborne botulism may try to remove contaminated food still remaining in the gastrointestinal tract by gastric lavage or enemas. In cases of wound botulism, the wound treated surgically is responsible for removing the source of toxigenic bacteria.
Moreover, each case of botulism creates an emergency to public health because it is necessary to identify the source of infection, and ensure that all persons who have been exposed to the toxin were identified and it has removed all the contaminated food.
Complications
Botulism can result in death from respiratory failure. However, over the last fifty years, the proportion of deaths among people with botulism has fallen about 50% to 8%. A patient with acute botulism may require respiratory support together with medical care and intensive nursing for several months. Patients who survive an episode of botulism poisoning may suffer from fatigue and breathlessness for several years, and long-term therapy may be necessary to help them recover.
Prevention of botulism
Food borne botulism has often been caused by canned homemade, low acid content, such as asparagus, green beans, beets and corn. However, outbreaks of botulism have been less common sources. In July 2002, fourteen Alaskans ate the meat of a beached whale, and eight of them presented symptoms of botulism, two of them have been treated by mechanical ventilation. Other sources of infection are the chopped garlic mixed with oil, peppers, tomatoes, potatoes baked mishandled and wrapped in aluminum foil, canned fish prepared to home and fermented fish. The domestic production of canned should obey strict hygienic precautions to avoid contamination. The garlic or spices mixed with oil are kept in the refrigerator. Potatoes baked and wrapped in aluminum foil should be kept hot until served or refrigerated.
Because botulinum toxin is destroyed at high temperature, it is safer to boil for ten minutes canned prepared at home before eating them. Canned can reveal the presence of C. botulinum by a domed exterior feature that results from pressure within the gas by the bacteria as waste discharge, it is best to simply discard such preserves. Like honey and other sweet foods are an ideal environment for the development of botulism, do not give their infants up to weaning, that is to say, until their digestive juices will become too acidic to allow bacteria to grow. Wound botulism can be prevented by consulting a doctor rapidly in cases of infected wounds and by not injecting drugs.
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