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Botulism

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Botulism

ABSTRACT
This paper will discuss how one becomes infected with botulism, how it affects the body systems, and the emergency management/ preparedness needed in order to effectively treat this disease. Botulism is a rare, naturally occurring disease that may be caused by deliberate or accidental exposure to the toxins of Clostridium botulinum. The three types of naturally occurring disease are food-borne, wound and intestinal colonization botulism, dependent on the route of ingress of the toxins. It may also be a result of biological terrorism. It presents with an afebrile, descending, symmetrical, flaccid paralysis of motor and autonomic but not sensory nerves. Respiratory failure can occur rapidly with little prior ventilatory deterioration. Management includes respiratory support, specific antitoxin and if wound related, surgical debridement and antibiotics. I will report different cases of botulism and discuss the presenting features that should alert the emergency physician to the diagnosis and direction of further treatment.

ASSESSMENT AND SYNTHESIS OF THE PROBLEM
Pathology
The rare toxin is a protein produced under anaerobic conditions by the bacterium Clostridium botulinum, and affects a wide range of animals, including mammals, birds and fish. Clostridium botulinum is a large anaerobic Gram-positive bacillus that forms sub-terminal endospores. There are seven serological varieties of the bacterium denoted by the letters A to G. The toxin from all of these acts in the same way and produces similar symptoms: the motor nerve endings are prevented from releasing acetylcholine, causing flaccid paralysis. When the bacterium is under stress, they develop spores. Their natural habitats are in the soil, in the silt that comprises the bottom sediment of streams, lakes and coastal waters and ocean, while some types are natural inhabitants of the

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