Clostridium botulinum: Difference between revisions
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Clostridium botulinum
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==Background== |
==Background== |
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===Microbiology=== |
===Microbiology=== |
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| + | |||
| − | * |
+ | *[[Stain::Gram-positive]] [[Cellular respiration::anaerobic]] [[Cellular shape::bacillus]] with a subterminal spore |
| − | * Produces seven toxin types, A through G |
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| + | *Diverse species whose defining trait is the production of botulinum toxin |
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| + | *Subdivided into four groups based on biochemical tests |
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| + | *These strains produce eight toxin types, A through H, that are identified by serology; some strains produce two different toxins |
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==Pathophysiology== |
==Pathophysiology== |
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| + | |||
| − | * |
+ | *Botulinum toxins are zinc-dependent metalloproteinases, and inhibit the release of acetylcholine from the presynaptic neuron |
==Clinical Presentation== |
==Clinical Presentation== |
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| + | |||
| − | * |
+ | *Typically involves ''symmetric'' descending paralysis, starting with cranial nerves and often involving respiratory muscles |
| − | * |
+ | *Afebrile with normal or slow heart rate despite hypotension, and sparing the sensory nerves |
| − | * |
+ | *This presentation contrasts with [[polio]], which can be asymmetric and often has fever |
===Foodborne botulism=== |
===Foodborne botulism=== |
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| + | |||
| − | * |
+ | *Symptoms start 12 to 36 hours after ingestion |
| − | * |
+ | *Nausea, diarrhea, and dry mouth |
| − | ** |
+ | **Of note, diarrhea is not caused by the toxin but by other ingested contaminants |
===Wound botulism=== |
===Wound botulism=== |
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| + | |||
| − | * |
+ | *Incubation period of t to 14 days |
| − | * |
+ | *May have fever secondary to an infected wound, although the wound can rarely appear to be healing well |
| − | * |
+ | *Can produce abscesses |
===Infant botulism=== |
===Infant botulism=== |
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| + | |||
| − | * |
+ | *Feeding difficulties, hypotonia, drooling, and weak cry |
| − | * |
+ | *Upper airway obstruction may require intubation |
| − | * |
+ | *Typically worsens over 1 to 2 weeks, then stabilizes for 2 to 3 weeks, then recovers |
| − | * |
+ | *Relapses are possible |
===Adult intestinal toxemia=== |
===Adult intestinal toxemia=== |
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| + | |||
| − | * |
+ | *Rare form of botulism associated with colonisation of the GI tract |
| − | * |
+ | *Onset is more gradual and disease less severe than foodborne botulism |
| − | * |
+ | *Risk factors are gastrointestinal surgery or illness, such as inflammatory bowel disease |
{{DISPLAYTITLE:''Clostridium botulinum''}} |
{{DISPLAYTITLE:''Clostridium botulinum''}} |
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Revision as of 21:23, 12 July 2020
Background
Microbiology
- Gram-positive anaerobic bacillus with a subterminal spore
- Diverse species whose defining trait is the production of botulinum toxin
- Subdivided into four groups based on biochemical tests
- These strains produce eight toxin types, A through H, that are identified by serology; some strains produce two different toxins
Pathophysiology
- Botulinum toxins are zinc-dependent metalloproteinases, and inhibit the release of acetylcholine from the presynaptic neuron
Clinical Presentation
- Typically involves symmetric descending paralysis, starting with cranial nerves and often involving respiratory muscles
- Afebrile with normal or slow heart rate despite hypotension, and sparing the sensory nerves
- This presentation contrasts with polio, which can be asymmetric and often has fever
Foodborne botulism
- Symptoms start 12 to 36 hours after ingestion
- Nausea, diarrhea, and dry mouth
- Of note, diarrhea is not caused by the toxin but by other ingested contaminants
Wound botulism
- Incubation period of t to 14 days
- May have fever secondary to an infected wound, although the wound can rarely appear to be healing well
- Can produce abscesses
Infant botulism
- Feeding difficulties, hypotonia, drooling, and weak cry
- Upper airway obstruction may require intubation
- Typically worsens over 1 to 2 weeks, then stabilizes for 2 to 3 weeks, then recovers
- Relapses are possible
Adult intestinal toxemia
- Rare form of botulism associated with colonisation of the GI tract
- Onset is more gradual and disease less severe than foodborne botulism
- Risk factors are gastrointestinal surgery or illness, such as inflammatory bowel disease
