Botulinum Toxin

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Botulinum toxin is the most lethal substance known. Six modes of disease have been recognized: (1) food-borne botulism from eating foods contaminated with C botulinum, (2) wound botulism from wounds harboring C botulinum, (3) infant (intestinal) botulism from intestinal overgrowth of C botulinum in children less than 1 year of age, (4) "undetermined" botulism from intestinal overgrowth of C botulinum in adults with surgically altered gastrointestinal tracts, (5) inadvertent (injection-related) botulism from accidental injection of Botox, and (6) inhalational botulism from aerosol exposure to botulinum toxin, as might occur in a terrorist release. Recognition of the clinical presentation characterized by bulbar palsies and descending paralysis in the absence of sensory or central nervous systems symptoms is key to making an early diagnosis. Current treatment is to administer the trivalent antitoxin against types A, B, E for adult forms, and human-derived Botulism Immune Globulin for infant botulism. A preventive pentavalent toxoid vaccine exists but must be given before exposure. Prolonged ventilator support may be required in patients with advanced paralysis.

Original languageEnglish (US)
Pages (from-to)825-839
Number of pages15
JournalCritical Care Clinics
Volume21
Issue number4
DOIs
StatePublished - Oct 2005

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Botulism
Botulinum Toxins
Paralysis
Progressive Bulbar Palsy
Toxoids
Antitoxins
Food
Injections
Mechanical Ventilators
Aerosols
Gastrointestinal Tract
Early Diagnosis
Vaccines
Central Nervous System
Eating
Wounds and Injuries

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Botulinum Toxin. / Horowitz, B (Zane).

In: Critical Care Clinics, Vol. 21, No. 4, 10.2005, p. 825-839.

Research output: Contribution to journalArticle

Horowitz, B (Zane). / Botulinum Toxin. In: Critical Care Clinics. 2005 ; Vol. 21, No. 4. pp. 825-839.
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