Clostridium botulinum
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Bacteria - Gram Positive
- Staph aureus: Overview
- Staph aureus: Presentation
- Methicillin-Resistant Staph aureus (MRSA)
- Staph saprophyticus
- Strep pneumoniae: Overview
- Strep pneumoniae: Presentation
- Strep viridans
- Strep pyogenes: Overview
- Strep pyogenes: Presentation
- Strep agalactiae
- Strep bovis
- Enterococcus
- Bacillus anthracis
- Bacillus cereus
- Clostridium tetani
- Clostridium perfringens
- Clostridium botulinum
- Clostridium difficile
- Corynebacterium diphtheriae
- Listeria monocytogenes
- Nocardia
- Actinomyces
Clostridium botulinum
- Characteristics
- Common to all bacteria in Clostridia family
- Gram + rods
- Obligate anaerobe
- Spore-forming
- Produces heat-labile exotoxin (botulinum)
- Blocks acetylcholine release in presynaptic neurons
- Cleaves SNARE proteins involved in neurotransmission
- This neurotoxin inhibits acetylcholine release from the nerve terminals at neuromuscular junctions and causes a descending flaccid paralysis.
- Blocks acetylcholine release in presynaptic neurons
- Exposure
- ingestion of preformed toxin in home-canned food in adults
- ingestion of spores in honey in infants
- Local botox injections used to treat focal dystonia, achalasia, and muscle spasms
- Also used for cosmetic reduction of facial wrinkles
- Presentation: botulism
- Descending flaccid paralysis in adults
- Usually begins with cranial nerves and descends down to skeletal muscle
- Contrast w Guillain-Barre syndrome - ascending paralysis
- Absent deep tendon reflexes
- 4 D’s
- Diplopia
- Dysarthria
- Dysphagia
- Dyspnea
- Usually begins with cranial nerves and descends down to skeletal muscle
- Floppy baby syndrome in infants
- Constipation, weakness, lethargy, reduced feeding
- Descending flaccid paralysis in adults
- Treatment
- Treat with human botulinum immunoglobulin