D104»c 0.02-0.9 min Bacteriophage Cattle and sheep (C, D), horse, mule, and birds (C)
home-prepared foods, but occasionally commercial products are involved.
Infant botulism is an infection that may follow the in vivo outgrowth and toxigenesis from C. botulinum spores. Infant botulism affects small children under 1 year of age, and is typically because of group I C. botulinum. Prolonged constipation, followed by distinctive flaccid paralysis that is manifested by impaired feeding, facial muscle paralysis, and general weakness, is typical. The symptoms of infant botulism may vary from a self-limiting constipation to unexpected death of a child, in which case it is occasionally misdiagnosed as sudden infant death syndrome.[8,9] The case fatality rate is less than 2%. The only foodstuff associated with infant botulism is honey, which may carry a high number of C. botulinum spores.[3,11] Dust and other environmental materials seem to be important sources of spores.[8,9]
Wound botulism is mainly found among injecting drug abusers using contaminated needles or impure heroin. Wound botulism is an infection that develops when C. botulinum spores germinate and grow in profound wounds or abscesses. The clinical picture is similar to food-borne botulism, with the absence of gastrointestinal signs. The median incubation period is 7 days. The estimated case fatality rate is 15%.
The adult form of infectious botulism is rare and resembles infant botulism in its pathogenesis and clinical status. People with altered intestinal flora because of abdominal surgery, prolonged antimicrobial treatment, or gastrointestinal wounds and abscesses may be affected.
Because a patient history of ingestion of toxic foods has typically not been found, the diagnosis of classical food-borne intoxication may be excluded.
Inhalation botulism may result from aerosolization of BoNT, and a few human cases have been reported. Iatrogenic botulism with local or generalized weakness is rare and has been reported to develop as a consequence of therapeutic injection of BoNT.
Preventive measures against food-borne botulism include proper handling, effective heat processing,1-16-1 and continuous cold storage of foods. The treatment of all forms of botulism basically involves the use of a therapeutic trivalent antitoxin and intensive symptomatic treatment, particularly respiratory support. In wound botulism, the treatment additionally consists of surgical debridement and antibiotic therapy.
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