Botulism in a patient with jejunoileal bypass

Freedman, Mervin B.; Armstrong, Richard M.; Killian, James M.; Boland, Dennis

doi:10.1002/ana.410200516

Cited by 24 publications

(11 citation statements)

References 8 publications

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“…It results from colonization of the intestinal tract by toxin-producing clostridia (40,64,143,145). People with altered intestinal flora due to abdominal surgery (76,111), prolonged antimicrobial treatment, or gastrointestinal wounds and abscesses are particularly vulnerable (40). Infectious botulism in adults is distinguished from the food-borne form by a different history of food consumption, with a missing association to foods with high risk of botulism (143).…”

Section: Infectious Botulism In Adultsmentioning

confidence: 99%

Laboratory Diagnostics of Botulism

2006

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SUMMARY Botulism is a potentially lethal paralytic disease caused by botulinum neurotoxin. Human pathogenic neurotoxins of types A, B, E, and F are produced by a diverse group of anaerobic spore-forming bacteria, including Clostridium botulinum groups I and II, Clostridium butyricum, and Clostridium baratii. The routine laboratory diagnostics of botulism is based on the detection of botulinum neurotoxin in the patient. Detection of toxin-producing clostridia in the patient and/or the vehicle confirms the diagnosis. The neurotoxin detection is based on the mouse lethality assay. Sensitive and rapid in vitro assays have been developed, but they have not yet been appropriately validated on clinical and food matrices. Culture methods for C. botulinum are poorly developed, and efficient isolation and identification tools are lacking. Molecular techniques targeted to the neurotoxin genes are ideal for the detection and identification of C. botulinum, but they do not detect biologically active neurotoxin and should not be used alone. Apart from rapid diagnosis, the laboratory diagnostics of botulism should aim at increasing our understanding of the epidemiology and prevention of the disease. Therefore, the toxin-producing organisms should be routinely isolated from the patient and the vehicle. The physiological group and genetic traits of the isolates should be determined.

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Section: Infectious Botulism In Adultsmentioning

confidence: 99%

Laboratory Diagnostics of Botulism

2006

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“…C. botulinum spores are highly prevalent in raw foods (Dodds, 1993), and it is more than likely that humans unintentionally ingest spores in their daily meals. However, in people with altered intestinal microbial population, due to, for example, abdominal surgery or heavy antibiotic treatments, such ingestion of C. botulinum spores may lead to infectious botulism (Isachson et al, 1985;Chia et al, 1986;Freedman et al, 1986). To the authors' knowledge, this is the first domestic case of human foodborne botulism in Finland.…”

Section: Discussionmentioning

confidence: 90%

“…Investigation of gastric samples rather than fecal specimens would therefore probably yield valuable information on the prevalence of C. botulinum spores in healthy humans. Such information could be helpful in estimating the risk of infectious botulism in adults, a rare form of botulism occurring as a result of in vivo outgrowth and subsequent toxin production from C. botulinum spores in the intestine (Isachson et al, 1985;Chia et al, 1986;Freedman et al, 1986). C. botulinum spores are highly prevalent in raw foods (Dodds, 1993), and it is more than likely that humans unintentionally ingest spores in their daily meals.…”

Section: Discussionmentioning

confidence: 98%

ProteolyticClostridium botulinumType B in the Gastric Content of a Patient with Type E Botulism Due to Whitefish Eggs

Lindström¹,

Hielm²,

Nevas³

et al. 2004

Foodborne Pathogens and Disease

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Whitefish eggs were confirmed by pulsed-field gel electrophoresis to cause type E foodborne botulism in a 54-year-old patient in Finland. Botulinum neurotoxin and/or nonproteolytic Clostridium botulinum type E organisms were detected in fecal and gastric samples from the patient and in suspected whitefish eggs. Apart from C. botulinum type E, proteolytic type B organisms were detected in the patient's gastric content. This was considered to be insignificant with respect to the clinical disease, suggesting botulinal spores to be occasionally present in the human gastrointestinal tract without any apparent clinical significance. This is the first domestic case of foodborne botulism in Finland.

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“…(ii) Wound botulism arises as a consequence of toxin produced in wounds contaminated with the clostridial bacterium. (Freedman et al 1986). (iii) Infant botulism is caused by the ingestion of botulinum spores that germinate in the infant's gastrointestinal tract and release toxin.…”

Section: Section IVmentioning

confidence: 99%

Biological Toxins and Bioterrorism

Gopalakrishnakone¹,

Balali-Mood²,

Llewellyn³

et al. 2015

Toxinology

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In recent years, the field of toxinology has expanded substantially. On the one hand it studies venomous animals, plants and micro organisms in detail to understand their mode of action on targets. While on the other, it explores the biochemical composition, genomics and proteomics of toxins and venoms to understand their three interaction with life forms (especially humans), development of antidotes and exploring their pharmacological potential. Therefore, toxinology has deep linkages with biochemistry, molecular biology, anatomy and pharmacology. In addition, there is a fast-developing applied subfield, clinical toxinology, which deals with understanding and managing medical effects of toxins on human body. Given the huge impact of toxin-based deaths globally, and the potential of venom in generation of drugs for so-far incurable diseases (for example, diabetes, chronic pain), the continued research and growth of the field is imminent. This has led to the growth of research in the area and the consequent scholarly output by way of publications in journals and books. Despite this ever-growing body of literature within biomedical sciences, there is still no all-inclusive reference work available that collects all of the important biochemical, biomedical and clinical insights relating to toxinology. Composed of 11 volumes, Toxinology provides comprehensive and authoritative coverage of the main areas in toxinology, from fundamental concepts to new developments and applications in the field. Each volume comprises a focused and carefully chosen collection of contributions from leading names in the subject.

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Botulism in a patient with jejunoileal bypass

Abstract: A 45-year-old woman was diagnosed as having the unclassified form of botulism. Her intestines may have been predisposed to colonization with Clostridium botulinum because of a jejunoileal bypass procedure that had been done several years earlier. One other similar case has been reported.

Cited by 24 publications

References 8 publications

Laboratory Diagnostics of Botulism

Laboratory Diagnostics of Botulism

ProteolyticClostridium botulinumType B in the Gastric Content of a Patient with Type E Botulism Due to Whitefish Eggs

Biological Toxins and Bioterrorism

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