BOLUTISM
An uncommon, but potentially very serious illness, a type of food poisoning, that produces paralysis of muscles via a nerve toxin called botulinum toxin (“botox”) that is manufactured by bacteria named Clostridium botulinum.
There are various types of botulism, including:
- Food-borne botulism — from eating food that contains the botulinum toxin.
- Wound botulism — caused by the toxin produced in a wound infected with the bacteria Clostridium botulinum.
- Infant intestinal botulism — when an infant consumes the spores of the bacteria, the bacteria grow in the baby’s intestines and release toxin.
- Adult intestinal botulism — due to infection with Clostridium botulinum in adults, typically following abdominal surgical procedures.
CAUSES
Clostridium botulinum is found in soil and untreated water throughout the world. It produces spores that survive in improperly preserved or canned food, where they produce a toxin. When eaten, even tiny amounts of this toxin can lead to severe poisoning. Foods that can be contaminated are home-canned vegetables, cured pork and ham, smoked or raw fish, and honey or corn syrup, baked potatoes cooked in foil, carrot juice, and chopped garlic in oil.
SIGNS AND SYMPTOMS
No matter how you get botulism, the symptoms are usually the same. The most defining symptom is weakness that starts on both sides of your face, goes down to your neck, and then to the rest of your body. 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. Later, you may have a very hard time urinating and have severe constipation.
Infants with botulism have symptoms that include:
- Lethargy
- Poor muscle tone starting in the head and neck and moving down
- Poor feeding
- Drooling
- Weak cry
DIAGNOSIS
To diagnose botulism, your doctor will check you for signs of muscle weakness or paralysis, such as drooping eyelids and a weak voice. Your doctor will also ask about the foods you’ve eaten in the past few days, and ask if you may have been exposed to the bacteria through a wound.
In cases of possible infant botulism, the doctor may ask if the child has eaten honey recently and has had constipation or sluggishness.
Analysis of blood, stool or vomit for evidence of the toxin may help confirm an infant or foodborne botulism diagnosis, but because these tests may take days, your doctor’s clinical examination is the primary means of diagnosis.
TREATMENT
For cases of foodborne botulism, doctors sometimes clear out the digestive system by inducing vomiting and giving medications to induce bowel movements. If you have botulism in a wound, a doctor may need to remove infected tissue surgically.
ANTITOXIN
If you’re diagnosed early with foodborne or wound botulism, injected antitoxin reduces the risk of complications. The antitoxin attaches itself to toxin that’s still circulating in your bloodstream and keeps it from harming your nerves.
ANTIBIOTICS
Antibiotics are recommended for the treatment of wound botulism. However, these medications are not advised for other types of botulism because they can hasten the release of the toxins.
BREATHING ASSISTANCE
If you’re having trouble breathing, you will probably need a mechanical ventilator for up to several weeks as the effects of the toxin gradually lessen.
REHABILITATION
As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by the disease.