Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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
Otros factores de diagnóstico
- 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
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- 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
Pruebas diagnósticas que deben considerarse
- electrophysiologic testing (electromyography)
Pruebas emergentes
- enzyme-linked immunosorbent assay (ELISA)
- polymerase chain reaction (PCR)
Algoritmo de tratamiento
foodborne botulism
wound botulism
iatrogenic botulism
inhalational botulism (biological attack)
Colaboradores
Autores
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
Divulgaciones
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.
Agradecimientos
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.
Divulgaciones
LSN is an author of a reference cited in this topic. TPB, AH, PR, and TZ declare that they have no competing interests.
Revisores por pares
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
Divulgaciones
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
Divulgaciones
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
Divulgaciones
WAP declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
World Health Organization. Botulism. Sep 2023 [internet publication].Texto completo
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.Texto completo Resumen
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. Resumen
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.Texto completo Resumen
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.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
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- Myasthenia gravis
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Más DiferencialesGuías de práctica clínica
- Clinical overview of botulism
- Botulism - guide for healthcare professionals
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