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Food poisoning
1.
2. FOODPOISIONING
Also known as food borne illness
It is any illness resulting from the consumption of
contaminated food , pathogenic bacteria , viruses or
parasites that contaminates food, as well as chemical
or natural toxins such as poisonous mushrooms.
Most cases of food poisoning are from clostridium
botulinum and other bacteria such as Staphylococcus
or E. coli.
Causes of food poisoning due to microbes, bacteria,
viruses, protozoa, parasites, fungi, plants, fish,
chemical additives
3. Common germs causing food
poisioning
Clostridium botulinum
Campylobacter enteritis
Cholera
E. coli enteritis
Fish poisoning
Staphylococcus aureus
Salmonella
Shigella
4. CLOSTRIDIUM BOTULINUM
Clostridium consists of gram positive anaerobic, spore
forming bacilli which are responsible for 3 major diseases.
Tetanus(cl.tetani),gas gangrene(cl.septicum,cl.fallax),food
poisoning(cl.botulinum).
Clostridium botulinum-8types A,B,C,C2,D,E,F&G.
A,B&E account for almost all cases of human botulism.
F&G are very rare in humans.
C&D are associated with botulism in mammalian animals
&birds.
5. Source : results from consumption of contaminated preserved
food,canned meat and meat products , vegetables and fish.
Wound botulism results from wound infection with
cl.botulinum.
Infant botulism most probably is caused by contaminated
honey.
Toxins : cl.botulinum produce a powerful exotoxin which is
produced intracellularly and is released only on the death and
autolysis of organism.
Lethal dose:1-2 microgram
Sunlight or heating at 80’C for 30 min or 100’C for 10 min
denatures the active toxin.
6. CLINICALFEATURES
Symptoms start within 2 - 6 hours after
eating the food.
Initial signs & symptoms of botulism may be
GI & can include abdominal pain, nausea,
vomiting & diarrhea.
most common serious complication of food
poisoning is dehydration — a severe loss of
water and essential salts and minerals
Pt may also present initially with only
neurologic signs & symptoms due to
cholinergic blockade.
Visual disturbance, dysarthria, dysphagia &
dry mouth are 4 most specific neurologic
symptoms.
7. Additional non specific neurologic symptoms:
Malaise
Generalized weakness
Head ache, dizziness & paresthesia.
Oculo bulbar symptoms: blurring of vision , lateral rectus
palsy , ptosis , dilated pupils.
10. General principles of
treatment
1. Oral rehydration therapy
It is preferred in mild dehydration 3-5% or
moderate dehydration 6-10%
In mild dehydration 50ml/kg should be
administered over a period of 2-4hrs which
should contain 50-90meq/l of sodium.
From moderate dehydration 100ml/kg is
administered
Later hydration status should be assessed if
found normal ,maintenance therapy can began.
11. 2. Maintenance therapy
1ml for diarrheal stool
10ml/kg for every watery stool passed
2ml/kg for each episode of vomiting
3.Intravenous rehydration
It is necessary when dehydration is severe(>10%
fluid loss)
20ml/kg boluses of ringer’s lactate,NS
Solution is administered until pulse , perfusion
and mental status returns to normal.
12. Non –specific anti diarrheal agents
Agents such as kaolin –pectin
Anti motility drugs
Anti-secretary drugs
13. Treatment of botulism
Monitoring of respiratory status
vital capacity
peak expiratory flow
pulse oxymetry
Attempt to evaluate GI tract of spores and toxin with
help of
activated charcoal
emesis
gastric lavage
catharsis
14. BOTULINUM ANTITOXIN
Trivalent botulinum anti toxin types A,B and E is an equene
globulin
GUANIDINE HCl
It shows low efficacy and high incidence of ADR
Dose-15-40mg/kg/day until improvement occurs
PENICILLIN
Benefit in wound botulism, penicillinG is preferred.
HUMAN –DERIVED BOTULISM IMMUNE GLOBULES
It’s a pentavalent types A,B,C,D and E harvested by plasma
pheresis from donors who received multiple
immunizations.