Botulism

Question 1

What is botulism?

Answer 1

It is a disease that is caused by a toxin produced in the immature intestines of young children resulting from infection with the bacterium Clostridium botulinum. It is rare but can cause serious paralytic illness

Question 2

What are the different types of botulism?

Answer 2

1. Food-borne botulism: d/t ingestion of food contaminated with botulinum toxin
2. Wound Botulism: results from wounds infected with C. botulinum
3. Infant botulism: most common in the United States and results from the ingestion of spores C. botulinum, most often from environmental dust. C. botulinum is common in soil and can also be found in a variety of foods, such as improperly preserved home-canned foods. It has been associated with feeding raw honey to infants; thus, these should be avoided in children younger than 1 year of age

Note:
The disease is not infectious; to become infected, the child must ingest the bacterial spores. These spores then multiply in the intestinal tract and produce the toxin, which is absorbed in the immature intestines of the infant. It is generally not a problem for older children because the bacteria do not grow well in mature intestines due to the presence of the normal intestinal flora.

Question 3

What are the complications if not treated?

Answer 3

• paralysis of the arms, legs and trunk
• respiratory system can develop

Question 4

What are the s/s?

Answer 4

• Common signs and symptoms in infants reported during the health history might include:
  Constipation
  Poor feeding
  Listlessness
  Generalized weakness
  Weak cry
• Common signs and symptoms in older children reported during the health history might include:
  Double vision
  Blurred vision
  Drooping eyelids
  Difficulty swallowing
  Slurred speech
  Muscle weakness

Question 5

Physical Examination and Laboratory and Diagnostic Tests

Answer 5

Assess for a diminished gag reflex, which is indicative of botulism. Diagnostic tests include cultures of stool and serum. Botulism is a rare disease and is difficult to diagnose since its symptoms are similar to those of other neuromuscular diseases. Therefore, assessment may include diagnostic tests to help rule out other diseases, such as Guillain–Barré syndrome, stroke, and myasthenia gravis.

Question 6

Nursing Management and Treatments

Answer 6

Interventions:
- maintain respiratory status and nutritional status

Tx:
- administer botulinum immune globulin