Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- ingestion of contaminated foods
- infant age group
- biologic terrorism
- blurred vision and diplopia
- impaired accommodation
- ptosis
- oculobulbar weakness
- hypoglossal weakness
- dysarthria
- dysphagia
- symmetrical descending flaccid paralysis
Другие диагностические факторы
- hypotonia
- weakened cry in infants
- feeding difficulties in infants
- postural hypotension
- hypothermia
- urinary retention
- constipation
- dry mouth and throat
- gastrointestinal illness
- diminished or absent deep tendon reflexes
- absence of fever
- respiratory dysfunction
- pupillary dilation
Факторы риска
- ingestion of contaminated foods
- ingestion of honey in infants
- ingestion of soil in infants
- intravenous drug use
- crush injury
- infant age group
- abnormal bowel anatomy
- therapeutic or cosmetic use of botulinum toxin
- biologic terrorism
- exposure to reptiles
Диагностические исследования
Исследования, которые показаны в первую очередь
- mouse bioassay of serum, gastric secretions, wound exudates, tissue specimens, stool, or food samples
- culture of food samples, gastric aspirates, wound exudates, tissue specimens, or fecal material
Исследования, проведение которых нужно рассмотреть
- electrophysiologic testing (electromyography)
Неотложные исследования
- enzyme-linked immunosorbent assay (ELISA)
- polymerase chain reaction (PCR)
Алгоритм лечения
foodborne botulism
wound botulism
iatrogenic botulism
inhalational botulism (biological attack)
Составители
Авторы
Maria Carrillo-Marquez, MD
Associate Professor
Department of Pediatrics
Division of Infectious Diseases
University of Tennessee Health Science Center
Le Bonheur Children’s Hospital
Memphis
TN
Раскрытие информации
MCM is a site principal investigator for a phase 2A multicenter study of Aztreonam-Avibactam (Pfizer) with no contractual obligation to disseminate product information. She has also conducted sponsored clinical research for activities unrelated to this topic, for which she does not personally receive honoraria.
Выражение благодарностей
Dr Maria Carrillo-Marquez would like to gratefully acknowledge Dr Linda S. Nield, Dr Thomas P. Bleck, Dr Aimee Hodowanec, Dr Pavani Reddy, and Dr Teresa Zembower, previous contributors to this topic.
Раскрытие информации
LSN is an author of a reference cited in this topic. TPB, AH, PR, and TZ declare that they have no competing interests.
Рецензенты
Fiona Cooke, MA, PhD, MSc, FRCPath, MRCP, DTM&H
Research Fellow and Medical Microbiologist
Wellcome Trust Sanger Institute
Department of Microbiology
Addenbrooke's Hospital
Cambridge
UK
Раскрытие информации
FC declares that she has no competing interests.
Christopher D. Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
Burlington
VT
Раскрытие информации
CDH declares that he has no competing interests.
William A. Petri, Jr, MD, PhD, FACP
Chief and Professor of Medicine
Division of Infectious Diseases and International Health
University of Virginia Health System
Charlottesville
VA
Раскрытие информации
WAP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
World Health Organization. Botulism. Sep 2023 [internet publication].Полный текст
Rao AK, Sobel J, Chatham-Stephens K, et al. Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021. MMWR Recomm Rep. 2021 May 7;70(2):1-30.Полный текст Аннотация
Arnon SS, Schechter R, Inglesby TV, et al. Botulinum toxin as a biological weapon: medical and public health management. JAMA. 2001 Feb 28;285(8):1059-70. Аннотация
Centers for Disease Control and Prevention (CDC). Investigational heptavalent botulinum antitoxin (HBAT) to replace licensed botulinum antitoxin AB and investigational botulinum antitoxin E. MMWR Morb Mortal Wkly Rep. 2010 Mar 19;59(10):299.Полный текст Аннотация
Arnon SS, Schechter R, Maslanka SE, et al. Human botulism immune globulin for the treatment of infant botulism. N Engl J Med. 2006 Feb 2;354(5):462-71.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Guillain-Barre syndrome (GBS)
- Myasthenia gravis
- Tick paralysis (Dermacentor)
Больше ОтличияРекомендации
- Clinical overview of botulism
- Botulism - guide for healthcare professionals
Больше Рекомендации
Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice
Использование этого контента попадает под действие нашего заявления об отказе от ответственности