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Assignment #3: Original - Clostridium botulinum

[edit]

Copied from Clostridium botulinum

Diagnostic methods

[edit]

In the US physicians may consider the diagnosis if the patient's history and physical examination suggest botulism. However, these clues are usually not enough to allow a diagnosis of botulism. Other diseases such as Guillain-Barré syndrome, stroke, and myasthenia gravis can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include a brain scan, spinal fluid examination, nerve conduction test (electromyography, or EMG), and a tensilon test for myasthenia gravis. Tests for botulinum toxin and for bacteria that cause botulism can be performed at some state health department laboratories and at CDC.[1]

Assignment #3: Editing of Clostridium botulinum

[edit]

Diagnosis

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Physicians may consider the diagnosis of botulism based on a patient’s clinical presentation, which classically includes an acute onset of bilateral cranial neuropathies and symmetric descending weakness.[2][3] Other key features of botulism include an absence of fever, symmetric neurologic deficits, normal or slow heart rate and normal blood pressure, and no sensory deficits except for blurred vision.[4] A careful history and physical examination is paramount in order to diagnose the type of botulism, as well as to rule out other conditions with similar findings, such as Guillain-Barre syndrome, stroke, and myasthenia gravis. Depending on the type of botulism considered, different tests for diagnosis may be indicated.

Foodborne Botulism: serum analysis for toxins by bioassay in mice should be done, as the demonstration of the toxins is diagnostic.[5]

Wound Botulism: isolation of C. botulinum from the wound site should be attempted, as growth of the bacteria is diagnostic.[6]

Adult Enteric and Infant Botulism: isolation and growth of C. botulinum from stool samples is diagnostic.[7] Infant botulism is a diagnosis which is often missed in the emergency room.

Other tests that may be helpful in ruling out other conditions are:

Treatments and Vaccines

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In the case of a diagnosis or suspicion of botulism, patients should be hospitalized immediately, even if the diagnosis and/or tests are pending. If botulism is suspected, patients should be treated immediately with antitoxin therapy in order to reduce mortality. Immediate intubation is also highly recommended, as respiratory failure is the primary cause of death from botulism.[11][12][13]

In Canada, there are currently only 3 antitoxin therapies available, which are accessible through Health Canada Special Access Program (SAP).[14] The 3 types of antitoxin therapies are: 1) GlaxoSmithKline trivalent Types ABE; 2) NP-018 (heptavalent) Types A to G from Cangene Corporation, and 3) BabyBIG®, Botulism Immune Globulin Intravenous (Human) (BIG-IV) for pediatric patients under the age of one year.

Outcomes vary between one to three months, but with prompt interventions, mortality from botulism ranges from less than 5 percent to 8 percent.[15]

Ichigo Ryu (talk) 08:48, 8 October 2017 (UTC)

Assignment #5: Updated - Clostridium botulinum

[edit]

Diagnosis

[edit]

Physicians may consider the diagnosis of botulism based on a patient’s clinical presentation, which classically includes an acute onset of bilateral cranial neuropathies and symmetric descending weakness.[16][17] Other key features of botulism include an absence of fever, symmetric neurologic deficits, normal or slow heart rate and normal blood pressure, and no sensory deficits except for blurred vision.[18][19] A careful history and physical examination is paramount in order to diagnose the type of botulism, as well as to rule out other conditions with similar findings, such as Guillain-Barre syndrome, stroke, and myasthenia gravis. Depending on the type of botulism considered, different tests for diagnosis may be indicated.

Foodborne Botulism: serum analysis for toxins by bioassay in mice should be done, as the demonstration of the toxins is diagnostic.[20]

Wound Botulism: isolation of C. botulinum from the wound site should be attempted, as growth of the bacteria is diagnostic.[21]

Adult Enteric and Infant Botulism: isolation and growth of C. botulinum from stool samples is diagnostic.[22] Infant botulism is a diagnosis which is often missed in the emergency room.

Other tests that may be helpful in ruling out other conditions are:

Treatments and Vaccines

[edit]

In the case of a diagnosis or suspicion of botulism, patients should be hospitalized immediately, even if the diagnosis and/or tests are pending. If botulism is suspected, patients should be treated immediately with antitoxin therapy in order to reduce mortality. Immediate intubation is also highly recommended, as respiratory failure is the primary cause of death from botulism.[26][27][28]

In Canada, there are currently only 3 antitoxin therapies available, which are accessible through Health Canada Special Access Program (SAP).[29] The 3 types of antitoxin therapies are: 1) GlaxoSmithKline trivalent Types ABE, 2) NP-018 (heptavalent) Types A to G, and 3) BabyBIG®, Botulism Immune Globulin Intravenous (Human) (BIG-IV) for pediatric patients under the age of one year.[30]

Outcomes vary between one to three months, but with prompt interventions, mortality from botulism ranges from less than 5 percent to 8 percent.[31]

Ichigo Ryu (talk) 19:13, 18 November 2017 (UTC)

  1. ^ "Diagnosis and Treatment: Botulism | CDC". cdc.gov. Centers for Disease Control and Prevention. Retrieved 7 February 2017.
  2. ^ Cherington, M. (June 1998). "Clinical spectrum of botulism". Muscle & Nerve. 21 (6): 701–710. ISSN 0148-639X. PMID 9585323.
  3. ^ Cai, Shuowei; Singh, Bal Ram; Sharma, Shashi (April 2007). "Botulism diagnostics: from clinical symptoms to in vitro assays". Critical Reviews in Microbiology. 33 (2): 109–125. doi:10.1080/10408410701364562. ISSN 1040-841X. PMID 17558660.
  4. ^ "Diagnosis and Treatment | Botulism | CDC". www.cdc.gov. Retrieved 2017-10-08.
  5. ^ Lindström, Miia; Korkeala, Hannu (2006-4). "Laboratory Diagnostics of Botulism". Clinical Microbiology Reviews. 19 (2): 298–314. doi:10.1128/CMR.19.2.298-314.2006. ISSN 0893-8512. PMC 1471988. PMID 16614251. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  6. ^ Akbulut, D.; Grant, K. A.; McLauchlin, J. (September 2005). "Improvement in laboratory diagnosis of wound botulism and tetanus among injecting illicit-drug users by use of real-time PCR assays for neurotoxin gene fragments". Journal of Clinical Microbiology. 43 (9): 4342–4348. doi:10.1128/JCM.43.9.4342-4348.2005. ISSN 0095-1137. PMC 1234055. PMID 16145075.{{cite journal}}: CS1 maint: PMC format (link)
  7. ^ Dezfulian, M; McCroskey, L M; Hatheway, C L; Dowell, V R (March 1981). "Selective medium for isolation of Clostridium botulinum from human feces". Journal of Clinical Microbiology. 13 (3): 526–531. ISSN 0095-1137. PMID 7016901.
  8. ^ O'Suilleabhain, P.; Low, P. A.; Lennon, V. A. (January 1998). "Autonomic dysfunction in the Lambert-Eaton myasthenic syndrome: serologic and clinical correlates". Neurology. 50 (1): 88–93. ISSN 0028-3878. PMID 9443463.
  9. ^ Mechem, C. C.; Walter, F. G. (June 1994). "Wound botulism". Veterinary and Human Toxicology. 36 (3): 233–237. ISSN 0145-6296. PMID 8066973.
  10. ^ Taraschenko, Olga D.; Powers, Karen M. (June 2014). "Neurotoxin-induced paralysis: a case of tick paralysis in a 2-year-old child". Pediatric Neurology. 50 (6): 605–607. doi:10.1016/j.pediatrneurol.2014.01.041. ISSN 1873-5150. PMID 24679414.
  11. ^ Witoonpanich, Rawiphan; Vichayanrat, Ekawat; Tantisiriwit, Kanit; Wongtanate, Manas; Sucharitchan, Niwatchai; Oranrigsupak, Petchdee; Chuesuwan, Aphinya; Nakarawat, Weeraworn; Tima, Ariya (March 2010). "Survival analysis for respiratory failure in patients with food-borne botulism". Clinical Toxicology (Philadelphia, Pa.). 48 (3): 177–183. doi:10.3109/15563651003596113. ISSN 1556-9519. PMID 20184431.
  12. ^ Sandrock, C. E.; Murin, S. (August 2001). "Clinical predictors of respiratory failure and long-term outcome in black tar heroin-associated wound botulism". Chest. 120 (2): 562–566. ISSN 0012-3692. PMID 11502659.
  13. ^ Wongtanate, Manas; Sucharitchan, Niwatchai; Tantisiriwit, Kanit; Oranrigsupak, Petchdee; Chuesuwan, Aphinya; Toykeaw, Sukumal; Suputtamongkol, Yupin (August 2007). "Signs and symptoms predictive of respiratory failure in patients with foodborne botulism in Thailand". The American Journal of Tropical Medicine and Hygiene. 77 (2): 386–389. ISSN 0002-9637. PMID 17690419.
  14. ^ Canada, Health. "Botulism - Guide for Healthcare Professionals - Canada.ca". www.canada.ca. Retrieved 2017-10-08.
  15. ^ pubmeddev. "No items found - PubMed - NCBI". Retrieved 2017-10-08.
  16. ^ Cherington, M. (June 1998). "Clinical spectrum of botulism". Muscle & Nerve. 21 (6): 701–710. ISSN 0148-639X. PMID 9585323.
  17. ^ Cai, Shuowei; Singh, Bal Ram; Sharma, Shashi (April 2007). "Botulism diagnostics: from clinical symptoms to in vitro assays". Critical Reviews in Microbiology. 33 (2): 109–125. doi:10.1080/10408410701364562. ISSN 1040-841X. PMID 17558660.
  18. ^ "Diagnosis and Treatment | Botulism | CDC". www.cdc.gov. Retrieved 2017-10-08.
  19. ^ "Botulism: Rare but serious food poisoning". Mayo Clinic. Retrieved 2017-11-18.
  20. ^ Lindström, Miia; Korkeala, Hannu (2006-4). "Laboratory Diagnostics of Botulism". Clinical Microbiology Reviews. 19 (2): 298–314. doi:10.1128/CMR.19.2.298-314.2006. ISSN 0893-8512. PMC 1471988. PMID 16614251. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  21. ^ Akbulut, D.; Grant, K. A.; McLauchlin, J. (September 2005). "Improvement in laboratory diagnosis of wound botulism and tetanus among injecting illicit-drug users by use of real-time PCR assays for neurotoxin gene fragments". Journal of Clinical Microbiology. 43 (9): 4342–4348. doi:10.1128/JCM.43.9.4342-4348.2005. ISSN 0095-1137. PMC 1234055. PMID 16145075.{{cite journal}}: CS1 maint: PMC format (link)
  22. ^ Dezfulian, M; McCroskey, L M; Hatheway, C L; Dowell, V R (March 1981). "Selective medium for isolation of Clostridium botulinum from human feces". Journal of Clinical Microbiology. 13 (3): 526–531. ISSN 0095-1137. PMID 7016901.
  23. ^ O'Suilleabhain, P.; Low, P. A.; Lennon, V. A. (January 1998). "Autonomic dysfunction in the Lambert-Eaton myasthenic syndrome: serologic and clinical correlates". Neurology. 50 (1): 88–93. ISSN 0028-3878. PMID 9443463.
  24. ^ Mechem, C. C.; Walter, F. G. (June 1994). "Wound botulism". Veterinary and Human Toxicology. 36 (3): 233–237. ISSN 0145-6296. PMID 8066973.
  25. ^ Taraschenko, Olga D.; Powers, Karen M. (June 2014). "Neurotoxin-induced paralysis: a case of tick paralysis in a 2-year-old child". Pediatric Neurology. 50 (6): 605–607. doi:10.1016/j.pediatrneurol.2014.01.041. ISSN 1873-5150. PMID 24679414.
  26. ^ Witoonpanich, Rawiphan; Vichayanrat, Ekawat; Tantisiriwit, Kanit; Wongtanate, Manas; Sucharitchan, Niwatchai; Oranrigsupak, Petchdee; Chuesuwan, Aphinya; Nakarawat, Weeraworn; Tima, Ariya (March 2010). "Survival analysis for respiratory failure in patients with food-borne botulism". Clinical Toxicology (Philadelphia, Pa.). 48 (3): 177–183. doi:10.3109/15563651003596113. ISSN 1556-9519. PMID 20184431.
  27. ^ Sandrock, C. E.; Murin, S. (August 2001). "Clinical predictors of respiratory failure and long-term outcome in black tar heroin-associated wound botulism". Chest. 120 (2): 562–566. ISSN 0012-3692. PMID 11502659.
  28. ^ Wongtanate, Manas; Sucharitchan, Niwatchai; Tantisiriwit, Kanit; Oranrigsupak, Petchdee; Chuesuwan, Aphinya; Toykeaw, Sukumal; Suputtamongkol, Yupin (August 2007). "Signs and symptoms predictive of respiratory failure in patients with foodborne botulism in Thailand". The American Journal of Tropical Medicine and Hygiene. 77 (2): 386–389. ISSN 0002-9637. PMID 17690419.
  29. ^ Canada, Health. "Botulism - Guide for Healthcare Professionals - Canada.ca". www.canada.ca. Retrieved 2017-10-08.
  30. ^ Canada, Health. "Botulism - Guide for Healthcare Professionals - Canada.ca". www.canada.ca. Retrieved 2017-11-18.
  31. ^ Varma, Jay K.; Katsitadze, Guram; Moiscrafishvili, Maia; Zardiashvili, Tamar; Chokheli, Maia; Tarkhashvili, Natalia; Jhorjholiani, Ekaterina; Chubinidze, Maia; Kukhalashvili, Teimuraz (2004-08-01). "Signs and symptoms predictive of death in patients with foodborne botulism--Republic of Georgia, 1980-2002". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 39 (3): 357–362. doi:10.1086/422318. ISSN 1537-6591. PMID 15307002.
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