Botulism

descending paralysis + anticholinergic
Etiology anaerobic, gram-positive, spore-forming rod which produces botulinum toxin. Exposure from food (home canning, honey) or wound.
Epidemiology Risk factors: IVDU
Clinical presentation Incubation 12-72h.
- dysarthria, dysphagia, constipation and urinary retention
- Oculobulbar weakness - ptosis, impaired accommodation → descending symmetrical paralysis
Pathogenesis toxin cleaves proteins required to release ACh within motor end plate and peripheral parasympatehtic nervous system - but no CNS penetration
Diagnostic investigations Toxin in serum/stool/food samples
Management Wound - Benpen or metronidazole
Antitoxin → obtain via Public Health England
Notifiable disease.

#toxicology #pathology #incomplete
https://emcrit.org/ibcc/nm/#botulism