Food poisoning
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  • 1. 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
  • 2. Common germs causing food poisioning  Clostridium botulinum  Campylobacter enteritis  Cholera  E. coli enteritis  Fish poisoning  Staphylococcus aureus  Salmonella  Shigella
  • 3. 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.
  • 4.  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.
  • 5. 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.
  • 6. Additional non specific neurologic symptoms:  Malaise  Generalized weakness  Head ache, dizziness & paresthesia.  Oculo bulbar symptoms: blurring of vision , lateral rectus palsy , ptosis , dilated pupils.
  • 7. MODEOFACTION  Botulinum toxin(heavy & light chain)  toxin absorbed  binds to pre synaptic nerve terminal  pre synaptic blockade
  • 8. DIAGNOSIS  Laboratory analysis  Tensilon test  Electromyography  History
  • 9. 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.
  • 10. 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.
  • 11. Non –specific anti diarrheal agents  Agents such as kaolin –pectin  Anti motility drugs  Anti-secretary drugs
  • 12. 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
  • 13. 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.
  • 14. THANK U