Infant botulism presents along a wide spectrum, from mild disease which may be transient to severe life threatening respiratory insufficiency at presentation or with progression. [clinicaladvisor.com]

Recognition of the clinical presentation characterized by bulbar palsies and descending paralysis in the absence of sensory or central nervous systems symptoms is key to making an early diagnosis. [ohsu.pure.elsevier.com]

The classic presentation is then a symmetrical, descending motor paralysis in an awake patient who has no sensory deficits. Food-borne botulism usually presents within 3 days of ingestion. [disastermedicine.wordpress.com]

Case presentation A 38-year-old male presents to the Emergency Department with nausea, vomiting and abdominal pain in the setting of blurred vision and difficulty swallowing over the last 12 hours. [calpoison.org]

• Weakness

  She had bilateral facial muscle weakness. She had mild weakness with shrugging her shoulders. She could move her extremities, but she could not stand and support her weight. The remainder of her exam was unremarkable. [vephealthcare.com]

  There are a few reports of mild generalized weakness caused by therapeutic injection, although this is rare. [academic.oup.com]

  […] cry, generalized muscular weakness ("floppy baby") and hypoventilation; half have upper airway obstruction and cranial nerve palsies ( Pediatr Neurol 2005;32:193 ) Has been associated with sudden infant death syndrome ( Lancet 1985;1:237, Lancet 1978 [pathologyoutlines.com]

  The symptoms of botulism include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness. [epi.publichealth.nc.gov]

  Diagnosis and Tests Your doctor will likely start with a physical exam, looking for signs of botulism such as muscle weakness, a weak voice, or drooping eyelids. She might also ask you about foods you (or your baby ) have eaten. [webmd.com]

• Fever

  Viral Hemorrhagic Fever Highly infectious RNA viruses including Ebola, Marburg, Lassa, and dengue fever. Spread by rodents, ticks, mosquitoes. Vary from one type of HFV to the next. include fever, muscle aches, exhaustion, internal bleeding. Varies. [pages.jh.edu]

  and arenaviruses (Lassa [Lassa fever], Junin [Argentine hemorrhagic fever], and related viruses). [cdc.gov]

  Botulinum toxin ingestion leads to a clinical syndrome characterised by cranial nerve palsies, oculobulbar weakness, and descending, symmetrical flaccid paralysis in the absence of fever. Affected patients do not complain of sensory deficits. [bestpractice.bmj.com]

  No sensory deficit, no fever, no lack of awareness History of exposure. [academic.oup.com]

  commonly followed by symmetric, descending, flaccid paralysis of involuntary muscles, which may result in respiratory compromise and death. ( 1 ) The sensorium remains intact because the botulism toxin does not cross the blood-brain barrier. ( 2 ) Fever [pedsinreview.aappublications.org]

• Pain

  Pain 1994;59(1):65-9. DOI: 10.1016/0304-3959(94)90048-5. 10. Gobel H. Botulinum toxin A in pain management: mechanisms of action and rationales for optimum use. Pain Headache. 2003;14:4-22. 11. Welch MJ, Purkiss JR, Foster KA. [resed.es]

  Fever, aches, vomiting, rash of small red spots that grow into larger, painful pustules covering the body. Fatal in 30 percent of unvaccinated patients. No treatment. U.S. has vaccine for about 6 million people. [pages.jh.edu]

  Article navigation February 2008 This article was originally published in Continuing Education in Anaesthesia Critical Care & Pain SpR, Intensive CareSt James's University HospitalBeckett StreetLeeds LS9 7TFUK Search for other works by this author on: [academic.oup.com]

  Other signs and symptoms include nausea and vomiting, abdominal pain, diarrhea, chest pain, cough, and pharyngitis. A maculopapular rash, prominent on the trunk, develops in most patients approximately 5 days after onset of illness. [cdc.gov]

• Wound Infection

  No instances of waterborn botulism have ever been reported. wound botulism caused by toxin production in a wound infected with Clostridium botulinum. [hancockcountyhealthdepartment.com]

  Wound botulism : Humans can come into contact with botulism when a wound is infected with bacteria. The bacteria then produce the toxin, which can spread throughout the whole body. [dph.illinois.gov]

  Wound botulism can be prevented by promptly seeking medical care for infected wounds and by not using injectable street drugs. Could botulism toxin be used for bioterrorism? Yes. [vdh.virginia.gov]

  Wound botulism results from an wound infected with C. botulinum. Adult colonization botulism results from colonization of the adult’s GI tract with the bacterium. [disastermedicine.wordpress.com]

  Though mainly a foodborne intoxication, human botulism can also be caused by intestinal infection with C. botulinum in infants, wound infections, and by inhalation. [who.int]

• Sudden Infant Death Syndrome

  It is believed that this maybe one of the causes of sudden infant death syndrome (SIDS). The final kind is inhalation botulism. This is not a natural form and is the man-made bioweapon form. [austincc.edu]

  […] half have upper airway obstruction and cranial nerve palsies ( Pediatr Neurol 2005;32:193 ) Has been associated with sudden infant death syndrome ( Lancet 1985;1:237, Lancet 1978;1:1273 ) Patients with foodborne botulism generally present with acute, [pathologyoutlines.com]

  Infant botulism exceptionally has been incriminated as cause of the sudden infant death syndrome. Botulinum toxin: Botulinum toxin is the most potent of all bacterial toxins. [histopathology-india.net]

  Although the case-fatality ratio for infant botulism in the US is less than 2%, the disease is suspected to be responsible for up to 5% of sudden infant death syndrome cases in California. [emedicine.medscape.com]

  Botulism has been implicated as a cause in some series of patients with sudden infant death syndrome (SIDS). [clinicaladvisor.com]

• Aspiration

  Sinus aspiration can be performed for patients with evidence of sinusitis [ 7 ]. Any material obtained from aspiration should be cultured anaerobically to isolate C. botulinum. [academic.oup.com]

  […] patients may die of respiratory paralysis or cardiac arrest Diagnosis A high index of suspicion is generally necessary for diagnosis Diagnosis is largely clinical through electromyographic studies PCR based assays for the bacteria in stool and gastric aspirates [pathologyoutlines.com]

  Samples from serum, stool and gastric aspirate should be obtained prior to administration for confirmatory testing. [calpoison.org]

  This often causes aspiration pneumonia. The patient may be unable to hold the head erect because of involvement of the neck muscles. Death, if it occurs, usually results from respiratory failure. [histopathology-india.net]

• Pneumonia

  Consult new chapters covering Ultrasound, Innate Immunity, Adaptive Immunity, Deposition and Clearance, Ventilator-Associated Pneumonia. [books.google.ro]

  Paralysis of the respiratory muscles can lead to pneumonia *. [humanillnesses.com]

  This often causes aspiration pneumonia. The patient may be unable to hold the head erect because of involvement of the neck muscles. Death, if it occurs, usually results from respiratory failure. [histopathology-india.net]

  **Indication:Indication: 1-wound type.1-wound type. 2-22-2ndnd bacterial infection as pneumonia.bacterial infection as pneumonia. [slideshare.net]

  Observation for and management of complications such as aspiration pneumonia, urinary tract infection, acute otitis media and other complications of long term hospitalization. 2. [clinicaladvisor.com]

• Pharyngitis

  Paralyses of pharyngeal muscles leads to regurgitation of ingested food and liquids through the nose. This often causes aspiration pneumonia. The patient may be unable to hold the head erect because of involvement of the neck muscles. [histopathology-india.net]

  In untreated persons, death results from airway obstruction due to pharyngeal and upper airway muscle paralysis and inadequate tidal volume due to paralysis of the diaphragm and accessory muscles of respiration. [rnceus.com]

  Without treatment, death results from airway obstruction (paralysis of pharyngeal and upper airway muscles) and respiratory failure (paralysis of diaphragm and accessory breathing muscles). [centerforhealthsecurity.org]

  Other signs and symptoms include nausea and vomiting, abdominal pain, diarrhea, chest pain, cough, and pharyngitis. A maculopapular rash, prominent on the trunk, develops in most patients approximately 5 days after onset of illness. [cdc.gov]

  Their death can arise from airway obstruction from pharyngeal muscle paralysis along with the paralysis of diaphragmatic and accessory respiratoy musculature. An almost universal symptom of progressing botulism is constipation. [physio-pedia.com]

• Hoarseness

  Patients are afebrile with initial complaints of blurred vision, diplopia, and mydriasis with photophobia, ptosis, ophthalmoplegia, hoarseness, dysarthric speech, and dysphagia. Constipation, dry mouth, and urinary retention may also occur. [visualdx.com]

  […] order, the following represents the classical temporal relationship: Early Symptoms (cranial nerve abnormalities precede peripheral muscle weakness): Blurred vision Diplopia (double vision) Dry mouth Later Symptoms (more severe disease): Dysphonia (hoarse [sccgov.org]

• Diarrhea

  In food-acquired cases, nausea, vomiting, and diarrhea may precede the paralysis, and cases will cluster around consumption of the contaminated food at a restaurant or from improper home canning. [visualdx.com]

  Other early symptoms include: Double or blurred vision Drooping eyelids Difficulty swallowing Slurred speech Shortness of breath Other symptoms that can follow include vomiting, belly pain, and diarrhea. [webmd.com]

  For example, scientists have identified genes that appear to be involved in signaling certain immune system cells to cause inflammation, which may contribute to the development of diarrhea. [wikilectures.eu]

  A 28-year-old man who used cocaine intranasally presented to an emergency department with a 12-h history of confusion, acute diplopia, and diarrhea. Clinical symptoms had appeared 2 h after he began inhaling cocaine. [academic.oup.com]

• Regurgitation

  Paralyses of pharyngeal muscles leads to regurgitation of ingested food and liquids through the nose. This often causes aspiration pneumonia. The patient may be unable to hold the head erect because of involvement of the neck muscles. [histopathology-india.net]

  This can lead to regurgitation as well as dysphagia. Other early symptoms: dysarthria, a lack of sweating, severe dry mouth and throat, and finally postural hypotension. Food-borne botulism may initially present with nausea and vomiting. [physio-pedia.com]

• Abdominal Cramps

  Foodborne As well as the symptoms listed above, symptoms of foodborne botulism may include: nausea vomiting diarrhoea abdominal cramping Infants In infants the following symptoms may occur: constipation poor suck altered cry weakness poor head control [sahealth.sa.gov.au]

• Heart Disease

  disease Hospital infections Immunisation Infectious diseases Ways infectious diseases spread Exclusion from childcare, preschool, school and work Handling blood and other body substances Breadcrumbs Botulism is an illness caused by botulinum toxin or [sahealth.sa.gov.au]

• Photophobia

  Symptoms include blurred vision due to mydriasis, diplopia, ptosis, and photophobia and dysarthria, dysphonia, and dysphagia. Flaccid skeletal muscle paralysis follows, in a symmetrical, descending, and progressive manner. [moh.gov.sg]

  Patients are afebrile with initial complaints of blurred vision, diplopia, and mydriasis with photophobia, ptosis, ophthalmoplegia, hoarseness, dysarthric speech, and dysphagia. Constipation, dry mouth, and urinary retention may also occur. [visualdx.com]

  Table 1 Symptoms and signs of botulism Cranial nerves Diplopia, blurred vision, photophobia, ptosis, dilated or fixed pupils, nystagmus, facial weakness, sore throat, dysphagia, dysarthria, dysphonia Peripheries Weakness in the neck and arms followed [academic.oup.com]

• Petechiae

  There may be petechiae and ecchymoses on serous surfaces and the in central nervous system as secondary effects of anoxia. There may be minute thromboses of small vessels, primarily in the brain and brain stem. [histopathology-india.net]

  Bleeding manifestations, such as petechiae, ecchymoses, and hemorrhages, occur as the disease progresses ( 8 ). [cdc.gov]

• Ulcer

  Oedematous skin ulcer covered by black eschar. Satellite vesicles may be present. Differential Diagnosis Guillain-Barre, myasthenia gravis, stroke, organophosphate poisoning, magnesium intoxication, atropine poisoning. [moh.gov.sg]

  An area of local edema becomes a pruritic macule or papule, which enlarges and ulcerates after 1--2 days. Small, 1--3 mm vesicles may surround the ulcer. A painless, depressed, black eschar usually with surrounding local edema subsequently develops. [cdc.gov]

• Skin Ulcer

  Oedematous skin ulcer covered by black eschar. Satellite vesicles may be present. Differential Diagnosis Guillain-Barre, myasthenia gravis, stroke, organophosphate poisoning, magnesium intoxication, atropine poisoning. [moh.gov.sg]

• Dysarthria

  Symptoms include blurred vision due to mydriasis, diplopia, ptosis, and photophobia and dysarthria, dysphonia, and dysphagia. Flaccid skeletal muscle paralysis follows, in a symmetrical, descending, and progressive manner. [moh.gov.sg]

  Look For Look for the classic triad of botulism: Symmetric descending flaccid paralysis with prominent bulbar palsies Afebrile patient Normal mental status Remember the "4 Ds" of the bulbar palsies: diplopia, dysarthria, dysphonia, and dysphagia. [visualdx.com]

  Common clinical features Symmetrical descending flaccid paralysis with prominent bulbar palsies including diplopia, dysarthria, dysphonia and dysphagia 4. Afebrile and no change in sensory awarness 4. [healthknowledge.org.uk]

  This can include blurred vision, diplopia, nystagmus, ptosis, dysphagia, dysarthria and facial weakness. Descending muscle weakness progresses to the trunk and upper extremities followed by the lower extremities. [vephealthcare.com]

  Table 1 Symptoms and signs of botulism Cranial nerves Diplopia, blurred vision, photophobia, ptosis, dilated or fixed pupils, nystagmus, facial weakness, sore throat, dysphagia, dysarthria, dysphonia Peripheries Weakness in the neck and arms followed [academic.oup.com]

• Stroke

  A stroke may occur when a blood vessel supplying the brain becomes clogged or bursts, depriving brain tissue of oxygen. [humanillnesses.com]

  More practical uses include treating strokes, traumatic brain injuries, and Parkinson's by easing muscle spasticity. [austincc.edu]

  […] spasticityPost-stroke spasticity 22. [slideshare.net]

  Differential Diagnosis Guillain-Barre, myasthenia gravis, stroke, organophosphate poisoning, magnesium intoxication, atropine poisoning. Laboratory investigations Blood and faeces for culture. Serum can also be sent to identify toxins. [moh.gov.sg]

  This includes myasthenia gravis, Lambert-Eaton myasthenic syndrome, tick paralysis, Guillain-Barre, poliomyelitis, stroke, heavy metal intoxication, tetrodotoxin, shellfish poisoning, and antimicrobial-associated paralysis. [vephealthcare.com]

• Descending Paralysis

  Recognition of the clinical presentation characterized by bulbar palsies and descending paralysis in the absence of sensory or central nervous systems symptoms is key to making an early diagnosis. [ohsu.pure.elsevier.com]

  The key clinical syndrome produced by C. botulinum toxin is an afebrile, descending, symmetrical, flaccid paralysis of motor and autonomic nerves. [academic.oup.com]

  Patients will present with cranial nerve palsies (diplopia, drooping eyelids, trouble swallowing or speaking), descending paralysis leading eventually to respiratory muscle paralysis and possibly GI symptoms. [disastermedicine.wordpress.com]

  paralysis (3) bilateral symptoms (4) no fever (5) clear sensorium (6) lack of sensory findings Food-borne toxin absorbed from small intestine home-canned fruit and vegetable ingestion symptoms within 12-36 hrs GI distress -> neuro symptoms parasympathetic [lifeinthefastlane.com]

  Botulism is characterized by a symmetric descending paralysis of cranial nerves, limbs and trunk. Botulism from contaminated food: Contamination of foodstuffs, especially vegetables, by the organism is therefore relatively common. [histopathology-india.net]

• Mydriasis

  Dilated pupils (mydriasis) are seen in approximately 50 percent of cases. Sensory symptoms usually do not occur. Oedematous skin ulcer covered by black eschar. Satellite vesicles may be present. [moh.gov.sg]

  Patients are afebrile with initial complaints of blurred vision, diplopia, and mydriasis with photophobia, ptosis, ophthalmoplegia, hoarseness, dysarthric speech, and dysphagia. Constipation, dry mouth, and urinary retention may also occur. [visualdx.com]

  All forms of botulism cause progressive weakness, bulbar signs (blurred vision, diplopia, mydriasis, dysphagia, and dysarthria), and respiratory failure with normal sensation and mentation. [link.springer.com]

  Clinical examination showed mydriasis, whereas the arterial pressure and respiratory rate were normal. He was observed over a 24-h period, but he refused hospital admission and returned home. [academic.oup.com]

• Dizziness

  Image courtesy Public Health Image Library (PHIL), Department of Health and Human Services, Centers for Disease Control and Prevention (CDC-USA) Signs and symptoms Symptoms may include: fatigue weakness vertigo (dizziness) blurred vision dry mouth difficulty [sahealth.sa.gov.au]

  […] syndrome ( Lancet 1985;1:237, Lancet 1978;1:1273 ) Patients with foodborne botulism generally present with acute, bilateral, symmetric cranial neuropathies Symptoms include lack of coordination of eye muscles, double vision, swallowing difficulties and dizziness [pathologyoutlines.com]

• Urinary Retention

  The autonomic effects of botulism are manifested by typical anticholinergic signs and symptoms such as dry mouth, ileus, constipation, and urinary retention. Nausea and vomiting may occur as non-specific sequelae of an ileus. [moh.gov.sg]

  Constipation, dry mouth, and urinary retention may also occur. Patients remain awake, alert, and oriented throughout the entire illness. [visualdx.com]

  Urinary retention and constipation are due to smooth muscle paralysis. Respiratory difficulties requiring intubation and mechanical ventilation are common because of diaphragmatic paralysis, upper airway compromise or both. [vephealthcare.com]

Data regarding maternal treatment with botulinum antitoxin are very limited but have not shown evidence of fetal harm, and where clinically indicated treatment with the antidote should not be withheld on account of pregnancy. [medicinesinpregnancy.org]

Affected people recovered within 2 weeks after antitoxin treatment. [health.nsw.gov.au]

Studies on the prophylaxis and treatment of botulism. In: Eaker D, Wadstrom T, eds. Natural Toxins. Oxford: Pergamon Press, 1980. Google Scholar 6. Metzger JF, Lewis GE Jr. Human-derived immune globulins for the treatment of botulism. [link.springer.com]

Botox treatments employ the purified and heavily diluted botulinum neurotoxin type A. [who.int]

Botulinum toxin treatment of movement disorders. Curr Treat Options Neurol. 2018;20(2):4. DOI: 10.1007/s11940-018-0488-3. 5. Jackson JL, Kuriyama A, Hayashino Y. [resed.es]

The prognosis is excellent for infants who received the human derived antitoxin. [physio-pedia.com]

Prognosis In general, with prompt diagnosis and appropriate management, the outcome of infant botulism is excellent. [clinicaladvisor.com]

Prognosis Recovery from botulism is often prolonged and may require extensive rehabilitation. Ventilatory muscle recovery invariably occurs but it is slow and variable. [academic.oup.com]

ETIOLOGY AND PATHOGENESIS Seven serologically distinct confirmed serotypes of botulinum toxin (A through G) have been confirmed. [accessmedicine.mhmedical.com]

[…] health care setting Recently, iatrogenic botulism has been reported due to botulinum toxin for cosmetic or therapeutic purposes ( Clin Neuropharmacol 2012;35:254, Clin Neuropharmacol 2010;33:158, Clin Neuropharmacol 2007;30:310, JAMA 2006;296:2476 ) Etiology [pathologyoutlines.com]

Etiology/Causes Clostridium botulinum [1] A gram-positive bacteria that produces spores anaerobically. This bacteria is found globally in soil and aquatic sediments. [8] Produces 7 immunologically distinct toxins designated by letters A-G. [physio-pedia.com]

Definition / general Botulism is a disease caused by botulinum toxin ("botox"), a potent neurotoxin produced by Clostridium botulinum or closely related microorganisms such as C. baratii or C. butyricum Epidemiology Botulism is uncommon in the developed [pathologyoutlines.com]

Epidemiology of Infectious Disease: Botulism Causal agent Botulism is caused by a neurotoxin produced by Clostridium botulinum 1. There are 7 neurotoxins (A-G); only types A, B, E and F cause illness in humans. [healthknowledge.org.uk]

National Surveillance Team – Enteric Diseases Epidemiology Branch. Centers for Disease Control and Prevention. http://www.cdc.gov/nationalsurveillance/botulism-surveillance.html Updated May 12, 2017. Accessed January 25, 2018. [rarediseases.org]

Comparative study of five different techniques for epidemiological typing of Escherichia coli O157. Diagn. Microbiol. Infect. Dis. 32, 165-176. ‎ [books.google.it]

The chapter discusses epidemiology of foodborne botulism. The defining feature of botulinogenic clostridia is that they produce botulinal neurotoxin. [asmscience.org]

Pathophysiology C botulinum is readily found in the soil and fresh- and salt-water environments. The toxin and spores are released as cells lyse. The spores can withstand heat up to 120 o C, the toxin lyses at temperatures of 85 o C. [disastermedicine.wordpress.com]

Pathophysiology The anaerobic bacteria, Clostridium botulinum, produces all seven serotypes of the botulinum neurotoxin (A through G). There are other Clostridium species that produce some of the toxin types as well. [calpoison.org]

Pathophysiology Infant botulism differs from adult forms of the disease in that active colonization of the gastrointestinal tract by viable organisms leads to disease, rather than ingestion or exposure to pre-formed toxins. [clinicaladvisor.com]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

Prevention Prevention of foodborne botulism is based on good practice in food preparation particularly during heating/sterilization and hygiene. [who.int]

Prevention Exclusion from childcare, preschool, school and work is not necessary. [sahealth.sa.gov.au]