Discover and read the best of Twitter Threads about #botulism
Most recents (5)
#idboardreview 30 M who injects heroin presents w/ weakness in arms and now legs are giving out followed by blurred doubled vision x12 hrs, +dyspnea, no sensory deficit, no GI sx. dx? #medEd #idmeded #idtwitter 
#botulism acute cranial nerve abnormalities+progressive descending paralysis: ingestion of preformed toxin in food or infection of wound w/ subsequent in vivo toxin production
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…
#idboardreview 12 prisoners from Mississippi jail present with varying symptoms of acute b/l cranial neuropathies and descending weakness after drinking 'hooch'. Diagnosis? #medEd #idmedEd
#botulism Hooch is defined as an illicitly made alcoholic beverage cdc.gov/mmwr/volumes/6…
honey, potatoes, apples & tomato paste from a bulging can were combined, hidden, fermented in sealed plastic bag at room temperature for 3–5 days. Possible sources of Clostridium botulinum or toxin include tomato paste, potatoes, contamination from the environment.
#idboardreview 55 F 🇪🇬Egyptian presents w/ hypotensive shock post 16hrs of abd pain, V & D, blurry vision, dyspnea, chest pain & difficulty speaking. +ophthalmoplegia +bilateral ptosis. 2d prior ate fesikh for Sham el-Nessim. Diagnosis? #medEd #IDMedEd
Food borne #botulism cdc.gov/mmwr/volumes/6…
