Adrian Jess Galindo

Botulism
Botulism is a rare but serious condition caused by toxins from bacteria called Clostridium
botulinum.
Botulism comes in several forms, with the three main forms being:
Infant botulism. This most common form of botulism begins after Clostridium
botulinum bacterial spores grow in a baby's intestinal tract. It typically occurs
between the ages of 2 and 6 months.
Foodborne botulism. The harmful bacteria thrive and produce the toxin in
environments with little oxygen, such as in canned food.
Wound botulism. If these bacteria get into a cut, they can cause a dangerous
infection that produces the toxin.
All types of botulism can be fatal and are considered medical emergencies.
Etiologic Agent
A potent neurotoxin produced from Clostridium botulinum, and rare strains of C.
butyricum and C. baratii, which are anaerobic, spore-forming bacteria .
Source of Infection
Home-canned foods, particularly low-acid foods, are the most common sources
Mode of Transmission
ingestion of inadequately cooked food or processed or refrigerated foods in which toxin
has formed, particularly canned and alkaline foods.
Incubation Period
Classical botulism occurs within 1236 hours (sometimes several days) after eating
contaminated food. The incubation period for infant botulism is unknown due to
difficulty in determining the precise time of ingestion. Shorter incubation periods are
associated with more severe disease and higher case-fatality rates.
Period of Communicability
weeks to months after onset of illness, no instance of secondary person-to-person
transmission has been documented. Foodborne botulism patients typically excrete the
toxin for shorter periods.
Clinical Manifestation
symmetric, descending flaccid paralysis of motor and autonomic nerves
Diagnostic Procedure
check for signs of muscle weakness or paralysis, such as drooping eyelids and a
weak voice.
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,

Adrian Jess Galindo

Treatment Modalities
Antitoxin
Breathing assistance
Mechanical Ventilator
Rehabilitation
As you recover, you may also need therapy to improve your speech, swallowing
and other functions affected by the disease.
Complications
The most immediate danger is that you won't be able to breathe, which is the most
common cause of death in botulism. Other complications, which may require
rehabilitation, may include:
Difficulty speaking
Trouble swallowing
Long-lasting weakness
Fatigue
Shortness of breath
Preventive Measures
Use proper canning techniques
Consider boiling these foods for 10 minutes before serving them.
Prepare and store food safely
Don't eat preserved food if its container is bulging or if the food smells spoiled.
Store oils infused with garlic or herbs in the refrigerator.
Infant botulism
avoid giving honey even a tiny taste to babies under the age of 1 year.
Wound botulism
never inject or inhale street drugs.
Nursing Management
Rigorous and supportive care is essential in patients with botulism.
Meticulous airway management is paramount, as respiratory failure is the most
important threat to survival in patients with botulism.
Spirometry, pulse oximetry, vital capacity, and arterial blood gases should be
evaluated sequentially.
Intubation and mechanical ventilation should be strongly considered when the
vital capacity is less than 30% of predicted, especially when paralysis is
progressing rapidly and hypoxemia with hypercarbia is present.
Tracheostomy may prove necessary to manage secretions.
Patients with bowel sounds are administered cathartics and enemas to remove
unabsorbed botulinum toxin from the intestine.
Magnesium salts, citrate, and sulfate should not be administered because
magnesium can potentiate the toxin-induced neuromuscular blockade.
A Foley catheter is often used to treat bladder incontinence. This must be
monitored conscientiously and changed regularly.