Botulism: The Daily PANCE Blueprint
A 43-year-old female presents via EMS to the ER due to blurred vision, diplopia, dysarthria, and trouble breathing. She ultimately has worsening respiratory distress, requiring intubation and mechanical ventilation. Per her family, the symptoms had started after a church potluck. Apparently, other attendees had similar issues but not to this severity. You later learn that a few children who attended the event had to also be admitted to the hospital due to flaccid paralysis. Which of the following is the most likely causative organism?
A. Clostridium botulinum
B. Shigella
C. Enterotoxigenic E. coli
D. Salmonella
E. Campylobacter jejuni
Answer and topic summary
The answer is A. Clostridium botulinum
Botulism is a life-threatening condition caused by the neurotoxin produced by Clostridium botulinum (gram-positive, rod-shaped, obligate anaerobic bacteria). There are different types/causes including foodborne botulism, infant botulism (associated with raw honey), wound botulism, etc. About 200 cases occur per year in the US. Clinical features include acute onset of cranial neuropathies (e.g., blurred vision, dysphagia, nystagmus, diplopia), symmetric descending weakness, and respiratory distress. The state health department should be contacted immediately. Specimens should be collected immediately for diagnostic testing for the toxin. Treatment includes appropriate airway management and the administration of antitoxin (human-derived botulism immune globulin for infant botulism and equine serum heptavalent BAT for non-infant botulism). Antibiotics are only recommended for wound botulism.
View blueprint lesson
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ ⇒
