User:Ichigo Ryu/sandbox

Assignment #3: Original - Clostridium botulinum
Copied from Clostridium botulinum

Diagnostic methods
In the US physicians may consider the diagnosis if the patient's history and physical examination suggest botulism. However, these clues are usually not enough to allow a diagnosis of botulism. Other diseases such as Guillain-Barré syndrome, stroke, and myasthenia gravis can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include a brain scan, spinal fluid examination, nerve conduction test (electromyography, or EMG), and a tensilon test for myasthenia gravis. Tests for botulinum toxin and for bacteria that cause botulism can be performed at some state health department laboratories and at CDC.

Diagnosis
Physicians may consider the diagnosis of botulism based on a patient’s clinical presentation, which classically includes an acute onset of bilateral cranial neuropathies and symmetric descending weakness. Other key features of botulism include an absence of fever, symmetric neurologic deficits, normal or slow heart rate and normal blood pressure, and no sensory deficits except for blurred vision. A careful history and physical examination is paramount in order to diagnose the type of botulism, as well as to rule out other conditions with similar findings, such as Guillain-Barre syndrome, stroke, and myasthenia gravis. Depending on the type of botulism considered, different tests for diagnosis may be indicated.

Foodborne Botulism: serum analysis for toxins by bioassay in mice should be done, as the demonstration of the toxins is diagnostic.

Wound Botulism: isolation of C. botulinum from the wound site should be attempted, as growth of the bacteria is diagnostic.

Adult Enteric and Infant Botulism: isolation and growth of C. botulinum from stool samples is diagnostic. Infant botulism is a diagnosis which is often missed in the emergency room.

Other tests that may be helpful in ruling out other conditions are:
 * Electromyography (EMG) or antibody studies may help with the exclusion of myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS).
 * Collection of cerebrospinal fluid (CSF) protein and blood assist with the exclusion of Guillan-Barre syndrome and stroke.
 * Detailed physical examination of the patient for any rash or tick presence helps with the exclusion of any tick transmitted tick paralysis.

Treatments and Vaccines
In the case of a diagnosis or suspicion of botulism, patients should be hospitalized immediately, even if the diagnosis and/or tests are pending. If botulism is suspected, patients should be treated immediately with antitoxin therapy in order to reduce mortality. Immediate intubation is also highly recommended, as respiratory failure is the primary cause of death from botulism.

In Canada, there are currently only 3 antitoxin therapies available, which are accessible through Health Canada Special Access Program (SAP). The 3 types of antitoxin therapies are: 1) GlaxoSmithKline trivalent Types ABE; 2) NP-018 (heptavalent) Types A to G from Cangene Corporation, and 3) BabyBIG®, Botulism Immune Globulin Intravenous (Human) (BIG-IV) for pediatric patients under the age of one year.

Outcomes vary between one to three months, but with prompt interventions, mortality from botulism ranges from less than 5 percent to 8 percent.

Ichigo Ryu (talk) 08:48, 8 October 2017 (UTC)

Diagnosis
Physicians may consider the diagnosis of botulism based on a patient’s clinical presentation, which classically includes an acute onset of bilateral cranial neuropathies and symmetric descending weakness. Other key features of botulism include an absence of fever, symmetric neurologic deficits, normal or slow heart rate and normal blood pressure, and no sensory deficits except for blurred vision. A careful history and physical examination is paramount in order to diagnose the type of botulism, as well as to rule out other conditions with similar findings, such as Guillain-Barre syndrome, stroke, and myasthenia gravis. Depending on the type of botulism considered, different tests for diagnosis may be indicated.

Foodborne Botulism: serum analysis for toxins by bioassay in mice should be done, as the demonstration of the toxins is diagnostic.

Wound Botulism: isolation of C. botulinum from the wound site should be attempted, as growth of the bacteria is diagnostic.

Adult Enteric and Infant Botulism: isolation and growth of C. botulinum from stool samples is diagnostic. Infant botulism is a diagnosis which is often missed in the emergency room.

Other tests that may be helpful in ruling out other conditions are:
 * Electromyography (EMG) or antibody studies may help with the exclusion of myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS).
 * Collection of cerebrospinal fluid (CSF) protein and blood assist with the exclusion of Guillan-Barre syndrome and stroke.
 * Detailed physical examination of the patient for any rash or tick presence helps with the exclusion of any tick transmitted tick paralysis.

Treatments and Vaccines
In the case of a diagnosis or suspicion of botulism, patients should be hospitalized immediately, even if the diagnosis and/or tests are pending. If botulism is suspected, patients should be treated immediately with antitoxin therapy in order to reduce mortality. Immediate intubation is also highly recommended, as respiratory failure is the primary cause of death from botulism.

In Canada, there are currently only 3 antitoxin therapies available, which are accessible through Health Canada Special Access Program (SAP). The 3 types of antitoxin therapies are: 1) GlaxoSmithKline trivalent Types ABE, 2) NP-018 (heptavalent) Types A to G, and 3) BabyBIG®, Botulism Immune Globulin Intravenous (Human) (BIG-IV) for pediatric patients under the age of one year.

Outcomes vary between one to three months, but with prompt interventions, mortality from botulism ranges from less than 5 percent to 8 percent.

Ichigo Ryu (talk) 19:13, 18 November 2017 (UTC)