clostridium botulinum disease
TRANSCRIPT
Introduction Clostridium botulinum: Gram Positive Rod , Spread everywhere
including water, earth, vegetable… Spore forming ,inactivated at higher temp
Anaerobic Spore forming ,inactivated at higher temp
Anaerobic Seven neurotoxin whose subtypes labeled
A_G ,All causes flaccid paralysis
Classification Class : Clostridia
Order : Clostridiale
Family : Clostridiaceae
Genus : Clostridium
Species: C. botulinum
History and Epidmiology Botulism = Botulus
For the first time the disease was eating sausages In U.S.A average 145 cases each year Approximately 15% food borne Approximately 65% infant form Approximately 20% wound form In IRAN : Gilan whit 79 case during 5 year the
most and Western Azerbaijan whit 4 case during 5 year least
Botulism Pathagenesis
Toxin inter blood stream from mucosal or wound bind to peripheral cholinergic nerve ending inhibits release of acetylcholine. preventing muscle from
contracting can result from airway obstruction or paralysis of respiratory
muscles
secondry complication related to prolonged ventilatory supportand intensive care
Human disease human contaminated by neurotoxin type A, B, E, F Type A is powerful toxin know in the earth type A Infection dos 0.09ng/kg So that a person weighing 90kg
with 0.9ng toxin A dies
three form disease :
Foodborne Wound Infant
Food borne botulism Second most common form caused by toxin ingested form contamination food including conserve, packing food, vegetable,
hot dog, kielbasa
Food borne botulism symptoms 12-36 h after Muscle weakness Diarrhea Blurred vision Vomiting Eventual paralysis
Wound botulism Organism and spore inter wound Develop under anaerobic conditions From ground in dirt or gravel It does not penetrate intact skin Associated whit addicts of black _ tar heroin
Infant botulism
Babies eat honey Most common form Affects babies from 1 week _ 1 year
Caused by
Ingestion contaminated food stuff Lack of breast milk House hold dust containing spores
Infant clinical signs Poor feeding Many gag Weak cry Decreased movement Appearing lethargic Flat, blunted facial expression Decreased muscle tone( hypotonia )
Adult clinical signs Nausea, vomiting, diarrhea Double vision Difficulty speaking or swallowing Descending weakness or paralysis Shoulders to arms to thighs to caw Symmetrical flaccid paralysis Respiratory muscle paralysis Causes temporary muscle paralysis that may take 3 to 6 months
Diagnosis
clinical signs Toxin in serum, stool, suspected food, gastric aspirate Culture of stool or gastric aspirate
(egg yolk agar , sxt ) Mouse neutralization test
Treatment Botulinum anti toxin Botulism immunoglobulin
Washing the stomach and the administration of antitoxin three valent( A ,B , E)
Penicillin , Metronidazole , Guanidine hydrochloride
Animal botulism Cattle and sheep (type C , D) Doge ( type C and few D )
Horses ( type B , C )
Foal ( type B )
Birds , poultry ( type C , E )
Achalasia Clinical: a primary esophageal motility disorder characterized by
the absence of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) in response to swallowing
Pathophysiology: a failure of smooth muscle fibers to relax, which can cause a sphincter to remain closed and fail to open when needed
Treatment: Mechanical(pneumatic dilation) Medical(botulinum toxin) Surgery( heller myotomy )
Bioterrorism Many countries :
Botulinum toxin as a biological weapon potential bioterrorism threat
A one-liter bottle of the toxin (type A ) could kill the entire population of Earth