Botulism


Clostridium botulinum is the bacteria that is responsible for botulism. It is a rare disease that attacks the central nervous system and its earlier symptoms include weakness, blurred vision, trouble in speech, tiredness, dropping of the eyelid, etc. The bacteria spores are found both in air and soil and when they grow into mature bacteria it releases toxins that mix with the bloodstream. These toxins then attached to the nerve and affect them.

Botulism is mainly of five types −

  • Infant botulism. In this type, the bacteria get into the intestine of the infant where it grows and produces toxins that affect the child.

  • Wound botulism. Wounds are also a door for bacteria to enter our body and mixed with the bloodstream and make their way to the central nervous system.

  • Foodborne botulism. Some of the items are already affected by botulism bacteria and when these food items are not cooked properly the bacteria don’t die and enter our system through the mouth. It grows inside our body and releases toxins.

  • Latrogenic botulism. Clostridium bacteria are also used for treatment purposes and it is injected into the body. Sometimes, the bacteria might be injected more in quantity, and this can be a reason for botulism.

  • Adult intestinal toxemia. It is similar to infant botulism the difference being the bacteria enter the intestine of an adult. The symptoms and development of bacteria are the same in all cases. The effect of bacteria is also serious and can be fatal.

Botulism: Causes

Botulism is caused by bacteria and the reason for it is the environment available for it to grow. Botulism is of five types and the cause for each is the same i.e. allowing it to grow bacteria. Botulism bacteria may cause severe damage to the respiratory organs. Breathing difficulty is the major reason for death. The following are the important causes of developing botulism −

  • Bacteria need some of the important criteria to grow like low oxygen levels, less heat, low sugar, salt, water, low acids, etc. When provided with this suitable environment, the bacteria grow.

  • For infant botulism, giving honey to newborns can be a major source of botulism.

  • Food borne botulism. Food items that are not been properly heated will carry the botulism bacteria and make them grow inside our body. Some fruits, vegetables, and fish can carry botulism bacteria.

  • Wound botulism. When a person is injured and the wound is not treated properly it may allow the bacteria to enter and get mixed with blood.

  • Latrogenic botulism. Getting botulism bacteria injected for treatment of other diseases or skin therapy from an inexperienced doctor can cause botulism.

Botulism: Symptoms

Effects of botulism are seen within 24 hours of bacteria affecting the body. The bacteria grow and develop spores that produce toxins that combine with blood and affect the nervous system of the body.

The patient with botulism mainly presents with the following symptoms −

  • Weakness in the muscles.

  • Difficulty chewing food.

  • Feeling restlessness.

  • Blurry vision

  • Dropping of eyelids.

  • Weakness in the body.

  • Difficulty in moving the eye.

  • Infant symptoms may include diarrhea, constipation, less facial expression, unusual crying sound, difficulty in breathing, dilated pupils, etc.

  • Foodborne botulism may show vomiting, diarrhea, pain in the stomach, dry mouth, and trouble speaking/ chewing. The patient may also have paralysis.

  • Similar symptoms are visible for wound botulism as for the foodborne category.

  • Latrogenic botulism. Most of the time botulism bacteria are injected for getting rid of wrinkles and therefore the symptoms are more in the face region. Face paralysis, headache, numbness in muscles, etc. are the common symptoms.

Botulism: Risk Factors

Several factors play an important role in the development of botulism which includes −

  • Drugs. Some people inject drugs into their skin which creates wounds and they don’t treat themselves and allow the bacteria to enter.

  • Eating canned food. Many people eat canned, packaged food and home-fermented food. These foods are the carrier of botulism bacteria, it is necessary to process and heat the food properly before eating.

  • Surgeries and Botox injections. Many of the personalities are taking Botox injections for anti-aging. These injections if not regulated properly cause more risk for iatrogenic botulism.

  • Giving honey to infants.

  • Alcohol. Some people make alcohol at home and they poorly ferment it and consume it, which allows the botulism bacteria to grow.

Botulism: Diagnosis

Botulism symptoms are visible and it is very important to reach your healthcare provider for checking it. He may diagnose by any of the following methods or a combination of methods.

  • Your doctor may ask you about the symptoms and physically check you. He will ask about the food you have taken in the last 48 hours to understand the situation.

  • He may also ask if you are taking any Botox injections for other treatments.

  • He may ask for brain scanning.

  • Stool and blood tests may be conducted to look for bacterial infection.

  • Spinal fluids may be examined by extracting a sample of the fluid.

  • Electromyography may be conducted to check the nerves and muscle functions.

Botulism: Treatment

The treatment is based on the severity of the symptoms. Once, you are diagnosed with botulism your doctor with straight away start the treatment by any of the methods.

  • Antitoxin. The bacteria might already have done severe damage to your body antitoxin may help to prevent the bacteria from further damage. The antitoxins will stop the toxins that are carried in the blood.

  • Antibiotics. Antibiotics may be prescribed if you have wound botulism. The doctor will remove the infected part and will give antibiotics.

  • Ventilators. Botulism can affect the respiratory system of the body and doctors may advise the use of ventilators to provide artificial breathing till the time lungs are restored.

  • Therapy. Speech therapy may be required to treat the effect of botulism.

Botulism: Prevention

Some of the measures that can help to prevent botulism include −

  • Proper cooking the canned food is very important.

  • Do not eat expired food or if they can shape is bad.

  • Use the refrigerator for storing the food.

  • Restrict using foils.

  • Do not inject drugs.

  • Keeps your wound clean.

  • Seek medical help with your wound if you notice any infections.

  • No honey for infants.

  • Do not drink homemade alcohol.

  • Take Botox injections from a qualified doctor and under his supervision.

  • Breastfeeding may help to reduce botulism’s effect on children.

  • Vaccines are under development till then prevention is very important.

Conclusion

Botulism is a disease caused by the bacteria Clostridium botulinum. It is present everywhere and can enter our system through food, wound, or Botox injections. The symptoms of botulism can easily be seen like dropping of eyelids, muscle pain, extreme weakness, diarrhea for food-borne botulism, etc.

Botulism treatment is very important; if not diagnosed and treated, it can become fatal. The bacteria can cause serious damage to respiratory organs, the central nervous system, the stomach, etc. It causes paralysis too. Botulism can be prevented by cooking the food properly and cleaning the wound.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 17-Apr-2023

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