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Botulism


Sapling caused by botulism sticks. Pathogen - anaerobic is widely distributed in nature, for a long time can be in the soil in the form of spores. It gets from the soil, from the intestines of farm animals, as well as some freshwater fish to various food products - vegetables, fruits, grains, meat, and so on. Without oxygen, for example, when preserving products, the botulinum bacteria begin to multiply and release a toxin, which is the strongest bacterial poison. It is not destroyed by intestinal juice, and some of its types (toxin type E) even strengthens its action. Typically, the toxin accumulates in foods such as canned food, salted fish, sausage, ham, mushrooms, cooked with a violation of technology, especially at home.
Symptoms and course:
The incubation period lasts from 2-3 hours to 1-2 days. The initial signs are general weakness, slight headache. Vomiting and diarrhea are not always, more often - persistent constipation, not amenable to the action of enemas and laxatives. When botulism affects the nervous system (blurred vision, swallowing, change in voice). The patient sees all the objects as if in a fog, double vision appears, the pupils are dilated, with one wider than the other. Often marked strabismus, ptosis - the omission of the upper eyelid of one of the eyes. Sometimes there is a lack of accommodation - the reaction of pupils to light. The patient experiences dry mouth, weak voice, slurred speech.
Body temperature is normal or slightly elevated (37.2-37.3 ± C), consciousness is preserved. With increased intoxication associated with germination of spores in the patient's intestines, the eye symptoms increase, there are disorders of swallowing (paralysis of the soft palate). Heart sounds become deaf, the pulse, initially slow, begins to accelerate, the blood pressure drops. Death can occur with respiratory paralysis.
Recognition:
It is carried out on the basis of anamnesis - the connection of the disease with the use of a certain food product and the development of similar phenomena in individuals who used the same product. In the early stages of the disease, it is necessary to distinguish botulism and poisoning by poisonous mushrooms, methyl alcohol, atropine. A differential diagnosis should be made with the bulbar form of poliomyelitis - according to ocular symptoms and temperature data (poliomyelitis produces a significant increase in temperature). The diagnosis confirms the detection of exotoxins in the blood and urine.
Treatment:
First aid - saline laxative (for example, magnesia sulphate), peach or other vegetable oil to bind toxins, gastric lavage with warm 5% sodium hydrogen carbonate solution (baking soda). And most importantly - the urgent introduction of anti-tonic serum. Therefore, all patients are subject to immediate hospitalization. In cases where it is possible to determine the type of toxin of a bacterium using a biological sample, a special monoreceptor antitoxic serum is used, which is directed against one particular type of exotoxin (eg type A or E). If this cannot be established, apply polyvalent - a mixture of sera A, B and E.
Careful care for the patient is needed, according to the indications, respiratory equipment is used, measures are taken to maintain the physiological functions of the body. In cases of swallowing disorders, artificial feeding is provided through a probe or nutrient enemas. Among the medications, chloramphenicol has an auxiliary effect (0.5 g 4-5 times a day for 5-6 days, as well as adenosyptriphosphate acid (intramuscularly 1 ml of 1% of the solution 1 time per day) in the first 5 days of treatment. Important follow the regularity of the chair.
Prevention:
Strict sanitary inspection of the food industry (fishing for fish - its drying, smoking, canning, slaughtering and meat processing).
Fulfillment of sanitary and hygienic requirements is also mandatory for home canning. Remember that the spores of botulism anaerobic microbes live in the soil, and multiply and release poison in conditions where there is no oxygen. Canned mushrooms that are not sufficiently cleared from the ground, where 1 spores, canned meat and fish cans from bloated cans, can be dangerous. Products with signs of poor quality are strictly prohibited: they have the smell of spicy cheese or rancid butter.