Botulism - is a disease resulting from poisoning bacteria botulism toxins and characterized by a heavy defeat of the nervous system. Causative agent - klostridiya botulism - widely distributed in nature with a permanent habitat in the soil. Forms disputes, it is extremely resistant to chemical and physical factors. Disputes withstand boiling 5 hours and only at a temperature of 120 degrees. Celsius die within 30 minutes. In an environment with little oxygen multiply and form a toxin. Toxin partially destroyed when heated to 70-80 degrees.
Celsius, while boiling over 5-15 minutes, destroyed completely. Botulotoksin - one of the strongest known poison in nature, its lethal dose for humans is about 0.3 micrograms. Reservoir agents of botulism in nature are warm, less cold-blooded animals, in the gut which are klostridii released from isprazhneniyami the outside environment. Sam agent does not cause human disease, only dangerous toxin. For poisoning outbreak must reproduction cause the accumulation botulotoksina in an environment with mlenkim oxygen (ham, sausage, canned, salted fish), as well as canned vegetables, fruit, mushrooms. In recent years, the occurrence of botulism has increased the role of canned mushrooms. The accumulation of toxins occurring particularly intensely at a temperature of 22-37 C.
The man falls ill, used in food products containing botulotoksin. The patient is dangerous to others. Botulinistichesky toxin enters the body through the human digestive tract with food. It is two exceptions to this rule is very rare - botulism infants whose producing toxin in the gut, and wound botulism, when the reproduction klostridy happening in omertvevshih tissues. Botulotoksin not destroyed enzymes gastrointestinal tract or through mucous membrane of the stomach and intestine absorbed into the blood, selectively affect different divisions of the nervous system. There paralysis of respiratory muscles, muscles of the larynx, pharynx. This leads to a violation of breathing, swallowing, which contributes to the development of pneumonia. It may develop sepsis (blood poisoning). Symptoms of botulism the incubation period - from several hours to 2-5 days; heavier than the disease, the shorter the incubation period. In severe forms of disease, it is usually about 24 hours.
The vast majority of cases, the disease begins quickly with nausea, vomiting, sometimes up to shvatkoobraznyh pain in the stomach, liquid stool without impurities, which continues some days. Then develop a sense of raspiraniya in the stomach, flatulence, constipation. Lost nervous system appear, or in conjunction with gastrointestinal or after their disappearance by the end of the first - the start of the second day. By the early signs of botulism include disturbance of view. Patients complain of "fog", "mesh" before the eyes of dvoenie, difficulty reading. At the same time, there are thirst, dry mucous membranes because of salivation, and swallowing disorder, changing quality of a voice. In doing so, patients are concerned about feeling "komka" in the throat, pain when glotanii, poperhivanie due to the defeat of the larynx and pharynx muscle. The defeat of the nervous system, accompanied by obschetoksicheskim syndrome - headache, dizziness, insomnia, weakness, rapid fatigue.
However, fever, usually absent, and only some patients was a slight increase in temperature. Grozny sign of a disadvantage during the illness, is a violation of breath. Patients lack of air, heaviness in the chest, sometimes pain in the chest, breathing becomes superficial. The cause of death in botulism is respiratory insufficiency. Diagnosis of botulism The diagnosis is established on the basis of laboratory research. An important role in the diagnosis of botulism is playing a panel of disease in humans, eat the same product (canned, stockfish, smoking, home cooking juices, canned vegetables, mushrooms and meat). Laboratory diagnostics: for the study took blood, vomit and wash water stomach, excrement, as well as remnants of food.
Availability botulotoksina to study the material is determined using biological method. Klostridii botulism under the microscope: Treatment of botulism All patients with suspected botulism subject to compulsory hospitalization because of the need for timely holding of a specific therapy to prevent possible serious complications.
The main objectives of emergency was reversed, binding and removal of toxins from the body, the functions of the respiratory and cardiovascular systems. At the prehospital phase, the following urgent measures: wash your stomach first boiled water, then 2-percent solution of sodium; abundant frequent drinking; enter intramuscularly or subcutaneously 2 ml of 0.05 per cent prozerina, while acute respiratory distress conduct artificial respiration. To neutralize botulotoksina apply therapeutic protivobotulinicheskie serum. If the unknown type of toxin causing the disease, imposing serum of three types - A, B, E. Seroterapii precede the intradermal test and desensitization. When severe form of disease entering the first dose of serum intravenously, in other cases - intramuscularly. Originally introduced by 10-15 thousand IU serum type A and E and 5-7,5 thousand IU serum type B.
Follow dosage and frequency of the introduction defines the severity of illness and the dynamics of clinical symptoms. With the introduction of severe forms of botulism serum repeat through 6-8 hours before impact. At full course of treatment cost up to 50 000-60 000 IU serum type A, E and 25 000-30 000 IU type, dose may be increased, but the rate serotherapy should not exceed three to four days. Given that the gastrointestinal tract disputes may become vegetative form appoint antibacterial therapy (levomitsetin) or drugs tetratsiklinovogo series. At the same time carry out detoxification therapy.
When breathing disorders due to paralysis of respiratory muscles showed Ventilator. To combat gipoksiey use of hyperbaric oxygen. For a long time recovering patients remain residual after paralysis (more than 1-2 months), asthenic syndrome. Botulism can be complicated by pneumonia, sepsis, miokarditom. Convalescent after discharge from hospital there: - If there are no complications - 14 days; - When complications during: when transferred myocarditis - a period of incapacity at least 10 days.
Treatment your cardiologist with the subsequent check-up every 6 months during the year with a study of blood and electrocardiogram; with residual neurologic symptoms - a period of incapacity of at least 2 weeks with further check-up at the infectious disease and neurologist during the year, the survey once every 3 months (ECG, clinical blood tests). Preventing botulism The main cause of the disease is the use of homemade products. Knowing the optimal conditions germination dispute toksinoobrazovaniya, resistance to the thermal effects of spores and toxins to determine adequate technological conditions food processing, precluding the accumulation of botulinum toxin. Before you use canned food is required to heat treatment.
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