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Pathology

Clostridium botulinum is a gram positive rod, produces heat-resistant neurotoxin leading to neuromuscular blockade.

Aetiology

Improperly preserved food, also contaminated heroin in IVDU.

Signs

Dilated pupils, ophthalmoplegia, reduced gag reflex, dysarthria.
If untreated eventually leads to respiratory depression and death..

Symptoms

Nausea, dry mouth, diarrhoea, dysphagia. 
Paralysis tends to affect the cranial nerves first, leading to diplopia

Investigations

Microbiology: Stool culture

Treatment

Medical: Benzylpenicillin, HDU/ITU.
Antitoxin: IM Antitoxin

Prognosis

Poor prognosis - 50% mortality
Difficulty speaking, trouble swallowing, weakness, fatigue, dyspnoea

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Key References

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