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Botulism, gas gangrene, and clostridial gastrointestinal infections 

Botulism, gas gangrene, and clostridial gastrointestinal infections
Chapter:
Botulism, gas gangrene, and clostridial gastrointestinal infections
Author(s):

Dennis L. Stevens

, Michael J. Aldape

, and Amy E. Bryant

DOI:
10.1093/med/9780198746690.003.0129
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date: 05 March 2021

Human botulism is caused by seven serological types of C. botulinum, which is ubiquitously distributed in the soil. Poisoning usually results from ingestion of preformed toxin in food, although this is rapidly inactivated at ordinary cooking temperatures, but it can also result from contaminated wounds. C. botulinum toxin binds irreversibly to the neuromuscular junction and is the most lethal known microbial toxin. There are five forms of clinical botulism: food-borne botulism; wound botulism; infant botulism; adult enteric infectious botulism; and inhalational botulism. Clinical presentation is with symptoms suggesting gastrointestinal tract illness, followed by neurological symptoms including diplopia, blurred vision, dizziness, and difficulty with speech or swallowing, leading on to generalized flaccid paralysis. The diagnosis can be confirmed by testing for botulinum toxin in the patient’s serum, urine, or stomach contents, or in the suspect food. Treatment requires supportive care, which may continue for many months.

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