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Nervous and Eye Diseases: Lecture 3 (Botulism (Treatment (maintain in open…
Nervous and Eye Diseases: Lecture 3
Botulism
not considered an infection
affect the synapses of the PNS
Foodborne
weak and dizzy, blurred vision, fixed dilated pupils, dry mouth, constipation, N/V, and abdominal pain
progressive paralysis on both sides of the body and pt remain mentally alert throughout illness
slow recovery from growth of new nerve cell endings years later; if death occurs then its from the fact the paralysis extends to the diaphragm
Infant
results from the ingestion of endospores not ingested foods where the bacterium actually grows in intestinal tract and then will secrete a toxin; non specific symptoms- crying, constipation, and fall to thrive
Wound
growth of bacterium in dead tissue after the introduction of endospores into the wound
s/s are similar to foodborne disease but incubation period is longer- 4 days
Pathogen: Clostridium botulinum; gram-positive endospore-forming bacillus; common in soil and water; endospore can survive improper canning of non-acidic foods
each of the ends of a motor neuron forms a synapse with a muscle cell called neuromuscular junction
ACh is used to communicate between neurons and muscle cells
Botulism will disrupt the communication by blocking the release of ACh by the motor neurons
when it blocks the ACh it can't communicate and the muscle does not contract and you get a flaccid paralysis
its permanent and irreversible and the blocked motor neuron axon can grow new branches
diagnosed by symptoms or from a culture from food, feces, or from pts
Treatment
maintain in open and functional airways
wash intestinal tract to remove virus
administer botulism immunoglobulin
Treat with antimicrobial drugs
prevent by destroying endospore and in contaminated food and infants under the age of 1 should not consume honey
Tetanus
s/s: tightening of neck and jaw muscles, profuse sweating, drooling, and grouchiness, spasms and contractions may spread to other muscles on back
violent spasms and contractions to other muscles becoming so severe that the arms and fists curl tightly, the feet curl down, body assumes a stiff backward arch as heels and back of head bend toward one another
irregular heartbeat and blood pressure- if toxins spread to neurons that control glands; unrelenting contractions of the diaphragm result in a final inhalation and then pts can die because they cant exhale
Clostridium tetani; produces a terminal endospore giving the cell a lollipop appearance; found in soil, dust, and intestines of humans and animals
produce neurotoxin, tetanospasmin, where they die and affects motor control by blocking release of inhibitory neurotransmitter in CNS
can acquire through any break in skin or mucous membrane
not like stepping on a rusty nail
most cases occur where immunization or adequate medical care is unavailable
Dx based on characteristic muscle contraction
Tx: wood cleaning to remove all the endospores, passive immunotherapy where antibodies are directed against tetanospasmin are injected, administering antimicrobial, active immunization
vaccine available for disease
Number of cases have declined as a result of tetanus toxoid