Botulism: The Daily PANCE Blueprint
Clinical features of botulism include all of the following except
A. Paresthesia
B. Dysphagia
C. Diplopia
D. Fixed/dilated pupils
Answer and topic summary
The answer is A: Paresthesia
Paresthesia is not a feature of botulism. All other options are features.
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Botulism Pearls
- Caused by a neurotoxin elaborated by Clostridium botulinum a gram-positive bacillus, which is an anaerobic, spore-forming bacteria
- Associated with home-canned food products and honey in infants (wait until babies are at least 12 months before introducing honey)
- Presents with double vision, drooping of eyelids, inability to make facial expressions, and difficulty swallowing
- Autonomic nervous system effects may cause dry mouth, postural hypotension, nausea, vomiting, and constipation
- Can lead to complete flaccid paralysis which is deadly if it involves respiratory muscles
- In infants, symptoms include constipation and generalized weakness, with weak crying, poor feeding, lethargy, and loss of head control (floppy baby syndrome)
Diagnosis
- Diagnosis is by toxin assays
- Sometimes electromyography
Treatment
- Treatment is supportive
- The greatest threat to life is respiratory impairment and its complications
- IV botulinum immunoglobulin/heptavalent botulinum antitoxin
- Correct canning and adequate heating of home-canned food before serving are essential
- Canned foods showing evidence of spoilage and swollen or leaking cans should be discarded
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Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ ⇒