Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
Outros fatores diagnósticos
- 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
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- mouse bioassay of serum, gastric secretions, stool, or food samples
- culture of food samples, gastric aspirates, or fecal material
Investigações a serem consideradas
- electrophysiologic testing
Novos exames
- enzyme-linked immunosorbent assay (ELISA)
- polymerase chain reaction (PCR)
Algoritmo de tratamento
foodborne botulism
wound botulism
iatrogenic botulism
inhalational botulism (biological attack)
Colaboradores
Autores
Linda S. Nield, MD, FAAP
Professor of Pediatrics and Medical Education
West Virginia University School of Medicine
Morgantown
WV
Declarações
LSN is an author of a reference cited in this topic.
Agradecimentos
Dr Linda S. Nield would like to gratefully acknowledge Dr Thomas P. Bleck, Dr Aimee Hodowanec, Dr Pavani Reddy, and Dr Teresa Zembower, previous contributors to this topic.
Declarações
TPB, AH, PR, and TZ declare that they have no competing interests.
Revisores
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
Declarações
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
Declarações
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
Declarações
WAP declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
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 Resumo
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. Resumo
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 Resumo
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 Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Guillain-Barre syndrome (GBS)
- Myasthenia gravis
- Tick paralysis (Dermacentor)
Mais Diagnósticos diferenciaisDiretrizes
- Clinical guidelines for diagnosis and treatment of botulism, 2021
- Botulism - guide for healthcare professionals
Mais Diretrizes
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