CBRNE - Botulism Follow-up

  • Author: Peter P Taillac, MD; Chief Editor: Robert G Darling, MD, FACEP   more...
 
Updated: Mar 23, 2010
 

Further Inpatient Care

  • Ventilatory support
  • Surgical debridement of wounds
  • Pediatric nutritional support: Intravenous feeding (hyperalimentation) is discouraged because of its potential for secondary infection and because of the success with nasogastric or nasojejunal tube feeding.
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Deterrence/Prevention

  • Inform the public about the hazards of improperly preserved or canned foods.
  • Inform expectant mothers not to administer honey to infants.
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Complications

  • Wound infection
  • Respiratory distress
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Prognosis

  • Prognosis is generally good with early detection, early antitoxin administration, and intensive supportive therapy.
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Contributor Information and Disclosures
Author

Peter P Taillac, MD  Associate Clinical Professor of Surgery, Division of Emergency Medicine, University of Utah Health Sciences Center

Peter P Taillac, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph Kim, MD  Chairman, Department of Emergency Medicine, Western Medical Center; Clinical Instructor, University of California, Irvine, School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Edward Bessman, MD  Chairman, Department of Emergency Medicine, John Hopkins Bayview Medical Center; Assistant Professor, Department of Emergency Medicine, Johns Hopkins University School of Medicine

Edward Bessman, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Barry J Sheridan, DO  Chief Warrior in Transition Services, Brooke Army Medical Center

Barry J Sheridan, DO is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Robert G Darling, MD, FACEP  Adjunct Clinical Assistant Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Associate Director, Center for Disaster and Humanitarian Assistance Medicine

Robert G Darling, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Telemedicine Association, and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

References

  1. McCroskey LM, Hatheway CL. Laboratory findings in four cases of adult botulism suggest colonization of the intestinal tract. J Clin Microbiol. May 1988;26(5):1052-4. [Medline].

  2. Mechem CC, Walter FG. Wound botulism. Vet Hum Toxicol. Jun 1994;36(3):233-7. [Medline].

  3. Arnon SS, Schechter R, Inglesby TV. Botulinum toxin as a biological weapon: medical and public health management. JAMA. Feb 28 2001;285(8):1059-70. [Medline].

  4. Bigalke H, Rummel A. Medical aspects of toxin weapons. Toxicology. Oct 30 2005;214(3):210-20. [Medline].

  5. Centers for Disease Control and Prevention. Botulism associated with commercially canned chili sauce--Texas and Indiana, July 2007. MMWR. Aug 3, 2007;56(30):767-9. [Medline].

  6. Dunbar EM. Botulism. J Infect. Jan 1990;20(1):1-3. [Medline].

  7. Fox CK, Keet CA, Strober JB. Recent advances in infant botulism. Pediatr Neurol. Mar 2005;32(3):149-54. [Medline].

  8. Freedman M, Armstrong RM, Killian JM. Botulism in a patient with jejunoileal bypass. Ann Neurol. Nov 1986;20(5):641-3. [Medline].

  9. Goonetilleke A, Harris JB. Clostridial neurotoxins. J Neurol Neurosurg Psychiatry. Sep 2004;75 Suppl 3:iii35-9. [Medline].

  10. Hatheway CL. Botulism: the present status of the disease. Curr Top Microbiol Immunol. 1995;195:55-75. [Medline].

  11. Horowitz BZ. Botulinum toxin. Crit Care Clin. Oct 2005;21(4):825-39, viii. [Medline].

  12. Mandell GL, Bennett JE, Dolin R. Clostridium botulinum. In: Principles and Practice of Infectious Diseases. 4th ed. 1995:2178.

  13. Marks JD. Medical aspects of biologic toxins. Anesthesiol Clin North America. Sep 2004;22(3):509-32, vii. [Medline].

  14. Mcnally RE, Morrison MB, Berndt JE, et al. Effectiveness of medical defense interventions against predicted battlefield levels of botulinum toxin A. Joppa, MD: Science Applications International Corp; 1994.

  15. Park JB, Simpson LL. Progress toward development of an inhalation vaccine against botulinum toxin. Expert Rev Vaccines. 2004;3(4):477-87. [Medline].

  16. Schmidt RD, Schmidt TW. Infant botulism: a case series and review of the literature. J Emerg Med. Nov-Dec 1992;10(6):713-8. [Medline].

  17. Shukla HD, Sharma SK. Clostridium botulinum: a bug with beauty and weapon. Crit Rev Microbiol. 2005;31(1):11-8. [Medline].

  18. Smith, LA; Rusnak, JM. Botulinum neurotoxin vaccines: past, present, and future. Crit Rev Immunol. 2007;27(4):303-18. [Medline].

  19. Ting PT, Freiman A. The story of Clostridium botulinum: from food poisoning to Botox. Clin Med. May-Jun 2004;4(3):258-61. [Medline].

  20. Underwood K, Rubin S, Deakers T, Neuth C. Infant botulism: a 30-year experience spanning the introduction of botulism immune globulin intravenous in the intensive care unit at Childrens Hospital Los Angeles. Pediatrics. Dec 2007;120(6):e1380-5. [Medline].

  21. Weber JT, Hoeprich PD, et al. Botulism. In: Jordan MC, et al, eds. Infectious Diseases. 5th ed. 1994:1185.

  22. Wenham TN. Botulism: a rare complication of injecting drug use. Emerg Med J. Jan 2008;25(1):55-6. [Medline].

  23. World Health Organization. Outbreak news. Botulism, Thailand. Wkly Epidemiol Rec. Mar 31 2006;81(13):118. [Medline].

 
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Bioterrorist Agents. Signs and symptoms. Chart courtesy of North Carolina Statewide Program for Infection Control and Epidemiology (SPICE), copyright University of North Carolina at Chapel Hill, www.unc.edu/depts/spice/bioterrorism.html.
Courtesy of Arnon SS, et al. Botulinum toxin as a biological weapon: medical and public health management. JAMA 2001 Apr 25;285:1059.
 
 
 
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