A patient with botulism was cured in the Infectious Disease Department: Vestnik Zname

Contamination can be with home-canned foods, salami, ham, smoked fish and other foods

A patient with botulism was successfully cured by the doctors in the Infectious Diseases Department of MBAL-Pazardzhik. The 52-year-old man presented with the typical manifestations – a mask-like face, paralysis, muscle weakness, low blood pressure and slow pulse.

“The patient was admitted in a damaged general condition and remained under treatment in the Infectious Diseases Department for 19 days. The disease was confirmed by the detection of toxin B in material from the patient. Treatment with anti-botulinum serum was carried out with a good effect,” explained the head of the department, Assoc. Dr. Maria Pishmisheva.

Since the beginning of 2023, 8 cases of botulism have been registered in Bulgaria. For comparison – in the previous year there was only 1.

Botulism is a severe intoxication characterized by the development of paralysis. It is caused by an exotoxin produced by the causative agent of the disease – the bacterium Clostridium botulinum /Clostridium botulinum/.

Botulinum exotoxin is the most potent biological poison known

8 types of toxin are known, and the disease is most often caused by toxins A, B, E. Botulism is a severe disease with high mortality.

The source of infection are domestic, wild animals and birds that pollute the environment with their feces. A person becomes infected most often by consuming home-preserved food /fruit, vegetables/, it is possible to become infected by eating salami, ham, smoked fish and other food products on which soil containing the spores of the bacterium came into contact. There is also wound botulism, in which spores land on an injured surface of the body, and recently this form has also been described in intravenous drug addicts. The disease is rare – cases are single, most often from one family.

In the absence of oxygen

and at low concentration of salt and sugar, low acidity and insufficient heat treatment, the spores survive, turn into vegetative forms that produce the exotoxin. The taste of contaminated food does not change, it is possible that the lids of the jars have been bombed. A sick person cannot infect.

The disease begins 18-36 hours after the consumption of the relevant food, less often after a longer period of time. Patients complain of heaviness and abdominal distension, there may be diarrhea and vomiting, but these are mild and transient. Visual disturbances are very characteristic –

the sick see dimly, as in a fog,

they can’t read, they have double vision. Typical complaints in this period are: fatigue, muscle weakness, low blood pressure, dry mouth and eyes, difficulty swallowing, difficulty speaking. Severe forms begin with respiratory disorders and the patient may die within hours. During the examination, a mask-like face is revealed due to the presence of paralysis – the eyeballs are immobile, the pupils are dilated and hardly react to light, the eyelids have fallen and the patients cannot look up. Constipation, urinary retention can be observed. Consciousness is preserved, and the temperature is normal at all times. The palsies are always bilateral, although not strictly symmetrical, and develop from top to bottom.

(Zn)