Discover and read the best of Twitter Threads about #botulinum
Most recents (3)
A salesman who got slapped by a lady customer when his right eye winked without his control
1. 45-year old man presented with involuntary #winking of right #eye of 6 months duration. It occurred several times in a day and he could not control them. He had no other symptoms.
1. 45-year old man presented with involuntary #winking of right #eye of 6 months duration. It occurred several times in a day and he could not control them. He had no other symptoms.
2. He was a salesman in a cosmetics shop and most of the customers were women.
It was a usual day for him at work when his right eye winked at a lady customer (while talking about a product). She misunderstood it and slapped him. All his explanation could not pacify her.
It was a usual day for him at work when his right eye winked at a lady customer (while talking about a product). She misunderstood it and slapped him. All his explanation could not pacify her.
3. With help from his boss and lengthy discussion with the woman's family, the matter was amicably resolved.
However, his job was at stake and he decided to seek a Neurologist's opinion.
However, his job was at stake and he decided to seek a Neurologist's opinion.
Weekend Digest
Name the pathogen
5 Clues
Gram-positive bacillus.
Spore.
Food. Wound. Iatrogenic.
Drooping eyelids.
Preserved sensory function.
Name the pathogen
5 Clues
Gram-positive bacillus.
Spore.
Food. Wound. Iatrogenic.
Drooping eyelids.
Preserved sensory function.
2/
#Clostridium #botulinum
Spore-forming Gram-positive bacillus
Ubiquitous: vegetable, soil, seafood
Neurotoxin: A-H (A, B, E cause human disease)
Toxin binds to receptor in presynaptic terminal —> blocks neurotransmitter release (blocks cholinergic neuromuscular innervation)
#Clostridium #botulinum
Spore-forming Gram-positive bacillus
Ubiquitous: vegetable, soil, seafood
Neurotoxin: A-H (A, B, E cause human disease)
Toxin binds to receptor in presynaptic terminal —> blocks neurotransmitter release (blocks cholinergic neuromuscular innervation)
3/
#Botulism (epidemiologic clues)
1. Infant botulism (raw honey)
2. Foodborne (preformed toxin; home-canned fermented food)
3. Wound botulism (IDU/ black tar heroin)
4. Iatrogenic (cosmetic use)
5. Bioterrorism (mass poisoning)
#Botulism (epidemiologic clues)
1. Infant botulism (raw honey)
2. Foodborne (preformed toxin; home-canned fermented food)
3. Wound botulism (IDU/ black tar heroin)
4. Iatrogenic (cosmetic use)
5. Bioterrorism (mass poisoning)
#MayoIDQ 69M was brought to the ED because of weakness. PE: intoxicated disheveled man with multiple skin ulcers / excoriations.
WBC 27. CK 1486. AST 76.
Wound culture: Clostridium botulinum
Which of the following is most consistent with wound botulism?
WBC 27. CK 1486. AST 76.
Wound culture: Clostridium botulinum
Which of the following is most consistent with wound botulism?
2/
#Botulism
#Botulinum neurotoxin binds to cholinergic nerve terminals and cleaves intracellular proteins needed for #acetylcholine release —> reduced acetylcholine —> neuromuscular blockade —> bulbar palsies, hypotonia, and symmetric, descending, #flaccid #paralysis.
#Botulism
#Botulinum neurotoxin binds to cholinergic nerve terminals and cleaves intracellular proteins needed for #acetylcholine release —> reduced acetylcholine —> neuromuscular blockade —> bulbar palsies, hypotonia, and symmetric, descending, #flaccid #paralysis.
3/
#Botulism
Clinical features
1. Flaccid paralysis
2. Prominent cranial nerve palsies
3. Descending progression
4. Symmetrical presentation
5. No sensory nerve dysfunction.
43% are correct in MCQ
cdc.gov/botulism/healt…
#Botulism
Clinical features
1. Flaccid paralysis
2. Prominent cranial nerve palsies
3. Descending progression
4. Symmetrical presentation
5. No sensory nerve dysfunction.
43% are correct in MCQ
cdc.gov/botulism/healt…
