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Botulism, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Rare in US, causing <200 cases/yr; however, has significant bioterrorism potential.

  • Caused by a polypeptide, heat-labile exotoxin produced by Clostridium botulinum:

    • Most potent pois...

Diagnosis

Signs and Symptoms

History

  • Ingestions/food history for previous 4–5 days:

    • Exposures traditionally from home-processed fruit or vegetable products

    • In prison populations ingestion of “pruno” (alco...

Treatment

Death is invariably from progressive ventilatory failure: 
  • Intubate as soon as respiratory insufficiency noted, clinically and/or in conjunction with ABG.

  • May require several weeks of ventilat...

Follow-Up

Disposition

Admission Criteria

Admit patients with suspected botulism poisoning to monitored bed: 
  • ICU admission for any respiratory deficiency

Discharge Criteria

Clinical course of botulism pois...

Pearls and Pitfalls

  • Botulism is a public health emergency; early consultation with state and federal health departments is required.

  • Suspect botulism if there are more than 2 cases; other conditions in...

Additional Reading

Codes

ICD9

  • 005.1 Botulism food poisoning

  • 040.41 Infant botulism

  • 040.42 Wound botulism

ICD10

  • A05.1 Botulism food poisoning

  • A48.51 Infant botulism

  • A48.52 Wound botulism

SNOMED

  • 398565003 Infection due to clostrid...

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