Symptoms and treatment of Botulism

Description

Botulism is a rare but serious illness caused by a toxin that attacks the nerves of the body. Botulism can cause life-threatening symptoms. A type of bacteria called Clostridium botulinum produces the toxin. Botulism can occur as a result of the food or the contamination of the wound. The condition may also occur when the bacterial spores grow in the intestines of infants. In rare cases, botulism can be caused by medical treatment or bioterrorism.

Three common forms of botulism are:

Foodborne botulism. The harmful bacteria thrive and make the toxin in environments with little oxygen, such as in home-canned food.
The wound botulism. If these bacteria get into a cut, which can cause a dangerous infection that makes the toxin.
Infant botulism. This most generic form of botulism begins after the spores of C. botulinum bacterium grows in a baby's intestinal tract. Usually occurs in children between the ages of 2 months and 8 months. In rare cases, this form of botulism bowel also affects adults.

Occasionally, the botulism occurs when the excess of the botulinum toxin is injected for cosmetic or medical reasons. This rare form is called iatrogenic botulism. The term "iatrogenic" means an illness caused by medical examination or treatment.

Another rare form of botulism can occur by the inhalation of toxins. This can occur as the result of bioterrorism.

All forms of botulism can be fatal and are considered a medical emergency.

Symptoms

Foodborne botulism

The symptoms of foodborne botulism typically begin 12 to 36 hours after the toxin gets into your body. But depending on how much toxin is consumed, the onset of the symptoms may vary from a few hours to a few days.

The symptoms of foodborne botulism include:

Difficulty swallowing or speaking
Dry mouth
Facial weakness on both sides of the face
Blurred or double vision
The droopy eyelids
Difficulty breathing
Nausea, vomiting, and stomach cramps
Paralysis

Wound botulism

Symptoms of wound botulism appear around 10 days after the toxin gets into your body. Wound botulism symptoms include:

Difficulty swallowing or speaking
Facial weakness on both sides of the face
Blurred or double vision
The droopy eyelids
Difficulty breathing
Paralysis

The area around the wound may not always appear swollen and show a color change.

Infant botulism

The problems generally begin 18 to 36 hours after the toxin enters the body of the baby. The symptoms include:

Constipation, which is often the first symptom
Floppy movements due to muscle weakness and difficulty to control the head
Weak cry
Irritability
Drooling
The droopy eyelids
Fatigue
Difficulty sucking or feeding
Paralysis

Some of the symptoms, in general, do not occur with botulism. For example, botulism usually does not elevate blood pressure or heart rate, or the cause of the fever or confusion. Sometimes, however, the wound botulism can cause a fever.

Iatrogenic botulism

In iatrogenic botulism — when the toxin is injected for cosmetic or medical reasons — there have been rare cases of serious side effects. These may include headache, facial paralysis, and muscle weakness.

When to see a doctor

Seek emergency medical attention if you suspect that you have botulism. Initial treatment increases their chances of survival and reduces the risk of complications.

Obtain medical attention quickly, it also can alert public health officials about the episodes of foodborne botulism. They may be able to prevent other people from eating contaminated food. Keep in mind, however, that the botulism cannot be spread from person to person.

An unusual cluster of botulism — especially in people who have no clear link — which develops in approximately 12 to 48 hours, may increase the suspicion of bioterrorism.

Causes

Foodborne botulism

The typical source of foodborne botulism is home-cooked food that is bad canned or preserved. These foods are generally fruits, vegetables, and fish. Other foods, like hot peppers (chiles), foil-wrapped baked potatoes and oil infused with garlic, can also be sources of botulism.

Wound botulism

When the C. botulinum bacteria enter a wound, they can multiply and make the toxin. The wound may be a cut that was not noticed. Or the wound can be caused by a traumatic injury or surgery.

Wound botulism has increased in the last few decades in people who inject heroin, which can contain spores of the bacteria. In fact, this form of botulism is most common in people who inject heroin black tar.

Infant botulism

Babies infant botulism when the spores of the bacteria reach the intestines and make the toxin. In some cases, the source of infant botulism can be the honey. But it is more likely the exposure to soils contaminated with the bacteria. In rare cases, this form of botulism bowel also affects adults.

Iatrogenic botulism

Rarely, the botulism occurs when the excess of the botulinum toxin is injected for cosmetic reasons, such as the removal of wrinkles, or for medical reasons, such as the treatment of migraines.

Complications

Because it affects control of the muscles of your entire body, the botulinum toxin can cause many complications. The most immediate danger is that you will not be able to breathe. Be unable to breathe is a common cause of death from botulism. Other complications, which may require rehabilitation, may include:

Difficulty speaking
Difficulty swallowing
Long-term weakness
Shortness of breath

Prevention

Foodborne botulism

The use of appropriate techniques for canning or food preservation in the home to make sure that the botulism germs are destroyed. It is also important to prepare and store food safely:

Pressure-cooking, home-canned foods to 250 degrees Fahrenheit (121 degrees Celsius) for 20 to 100 minutes, depending on the food.
Think about boiling of these foods for 10 minutes before serving.
Do not eat preserved food if its container is the protrusion or if the food smells bad. But, the taste and the smell does not always give away the presence of C. botulinum. Some strains do not make food a bad taste or smell strange.
If you wrap the potatoes in foil before baking, eating hot. Loosen the foil and store potatoes in the refrigerator and not at room temperature.
Store homemade oils infused with garlic or herbs in the refrigerator. Get rid of them after four days.
Refrigerate canned foods after the open.

Wound botulism

To prevent the wound botulism, and other diseases, serious bloodborne, never inject or inhale drugs on the street. Keep the wounds clean to prevent infection. If you think that a wound is infected, seek medical attention immediately.

Infant botulism

To reduce the risk of infant botulism, avoid giving honey — even a tiny taste of children under the age of 1 year.

Iatrogenic botulism

To avoid iatrogenic botulism, make sure you go to a doctor with a license to any cosmetic or medical procedures that use various forms of botulinum toxin. They include onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport), and others.

Diagnosis

To diagnose botulism, the doctor finds that the muscle weakness or paralysis. Your provider seeks to symptoms such as drooping of the eyelids and a faint voice. Your healthcare provider will ask about the food that you have eaten in the past few days. Try to find out if you have been exposed to the bacteria through a wound.

In possible cases of infant botulism, the provider may ask if your child has eaten the honey recently. The doctor may also ask you if your baby is constipated or has been less active than usual.

Analysis of blood, feces or vomit of the evidence that the toxin may help confirm a diagnosis of your baby or the foodborne botulism. But to get these results can take days. So the provider of the test is the main way of diagnosing botulism.

Treatment

For cases of foodborne botulism, health care providers sometimes clean out the digestive system, causing vomiting and give you medication to help move your bowels. If you have a wound botulism, a provider may need to remove the infected tissue in a surgery.

Symptoms related to the injections of botulinum toxin for cosmetic or medical reasons usually improve as the toxin is absorbed by the body.

Antitoxin

If you are diagnosed early with the food or wound botulism, it is injected antitoxin reduces the risk of complications. The antitoxin is attached himself to the toxin that is moving through your bloodstream and keeps from damaging the nerves.

The antitoxin will not reverse the damage that has already been done. But the nerves can repair themselves. Many people recover fully. But recovery can take months, and it typically involves long-term rehabilitation therapy.

A different type of antitoxin, known as botulism immune globulin, is used for the treatment of babies.

Antibiotics

Antibiotics are recommended for the treatment of wound botulism. These drugs are not used for other forms of botulism, as they can accelerate the release of toxins.

Respiratory assistance

If you are having trouble breathing, you probably need a mechanical ventilator for several weeks, while your body fight against the effects of the toxin. The fan that forces air into their lungs through a tube inserted into the airway through the nose or mouth.

Rehabilitation

As you recover, you may also need therapy to improve their speech, swallowing, and other functions affected by botulism.

Preparing for your appointment

You can start by seeing your doctor. Or you may be referred immediately to a hospital for treatment. In the hospital, you can probably see several health care providers, including those that specialize in neurology (neurologist), and infectious diseases.

What you can do

When you make your appointment, make a list of:

Your symptoms, including any that seem unrelated to the reason for your appointment
Key personal information, including major stresses, recent life changes, and the medical history of the family
All the medications, vitamins, or other supplements you are taking, including dose
Questions to ask your doctor

Have a friend or family member, if possible, to help you remember the information they give you.

For botulism, some basic questions to ask your provider include:

How can I get botulism?
I'm going to have long-term problems?
What side effects can I expect from treatment?
There are restrictions in the diet should I follow?
How can I prevent this from happening again?

Do not hesitate to ask other questions.

What to expect from your doctor

Your provider is likely to ask several questions, such as:

When did your symptoms begin?
The symptoms been continuous or occasional?
How severe are the symptoms?
Have you or your child eats any home-canned food recently?
If your baby is sick, you have your baby eat honey?
Did anyone else eat the food suspected of doing wrong?