Clostridium botulinum is a gram positive, spore-forming bacterium that produces botulinum toxin, which causes flaccid paralysis. There are seven subtypes of botulinum toxin labeled A-G. C. botulinum spores are found worldwide in soil and can contaminate food. Botulism results from ingesting, inhaling, or having an open wound exposed to the toxin. Symptoms include muscle weakness, paralysis, and respiratory failure. Treatment involves an antitoxin administration and supportive care.

1. Clostridium botulinum
GATHER BY BEHROUZ LATIFI

2. Introduction
 Clostridium botulinum:
 Gram Positive Rod , Spread everywhere
including water, earth, vegetable…
 Spore forming ,inactivated at higher temp
Anaerobic
 Spore forming ,inactivated at higher temp
Anaerobic
 Seven neurotoxin whose subtypes labeled
A_G ,All causes flaccid paralysis

3. Classification
 Class : Clostridia
 Order : Clostridiale
 Family : Clostridiaceae
 Genus : Clostridium
 Species: C. botulinum

4. History and Epidmiology
 Botulism = Botulus
For the first time the disease was eating sausages
 In U.S.A average 145 cases each year
 Approximately 15% food borne
 Approximately 65% infant form
 Approximately 20% wound form
 In IRAN : Gilan whit 79 case during 5 year the most and
Western Azerbaijan whit 4 case during 5 year
least

5. Transmission
 1) Ingestion
organism
spores
neurotoxin
 2) Wound contamination
 3) Inhalation

6. Botulism Pathagenesis
 Toxin inter blood stream from mucosal or wound
 bind to peripheral cholinergic nerve ending
 inhibits release of acetylcholine. preventing muscle from contracting
 can result from airway obstruction or paralysis of respiratory muscles
 secondry complication related to prolonged ventilatory supportand
intensive care

7. Human disease
 human contaminated by neurotoxin type A, B, E, F
 Type A is powerful toxin know in the earth
 type A Infection dos 0.09ng/kg So that a person weighing 90kg with
0.9ng toxin A dies
 three form disease :
 Foodborne
 Wound
 Infant

8. Food borne botulism
 Second most common form
 caused by toxin ingested form
 contamination food including conserve, packing food, vegetable, hot
dog, kielbasa

9. Food borne botulism symptoms
 12-36 h after
 Muscle weakness
 Diarrhea
 Blurred vision
 Vomiting
 Eventual paralysis

10. Wound botulism
 Organism and spore inter wound
 Develop under anaerobic conditions
 From ground in dirt or gravel
 It does not penetrate intact skin
 Associated whit addicts of black _ tar heroin

11. Infant botulism
 Babies eat honey
 Most common form
 Affects babies from 1 week _ 1 year
 Caused by
 Ingestion contaminated food stuff
 Lack of breast milk
 House hold dust containing spores

12. Infant clinical signs
 Poor feeding
 Many gag
 Weak cry
 Decreased movement
 Appearing lethargic
 Flat, blunted facial expression
 Decreased muscle tone( hypotonia )

13. Adult clinical signs
 Nausea, vomiting, diarrhea
 Double vision
 Difficulty speaking or swallowing
 Descending weakness or paralysis
 Shoulders to arms to thighs to caw
 Symmetrical flaccid paralysis
 Respiratory muscle paralysis
 Causes temporary muscle paralysis that may take 3 to 6 months

14. Diagnosis
 clinical signs
 Toxin in serum, stool, suspected food, gastric aspirate
 Culture of stool or gastric aspirate
(egg yolk agar , sxt )
 Mouse neutralization test

15. Treatment
 Botulinum anti toxin
 Botulism immunoglobulin
 Washing the stomach and the administration of antitoxin three valent( A
,B , E)
Penicillin , Metronidazole , Guanidine hydrochloride

16. Animal botulism
 Cattle and sheep (type C , D)
 Doge ( type C and few D )
 Horses ( type B , C )
 Foal ( type B )
 Birds , poultry ( type C , E )

17. Achalasia
 Clinical: a primary esophageal motility disorder characterized by the
absence of esophageal peristalsis and impaired relaxation of the lower
esophageal sphincter (LES) in response to swallowing
 Pathophysiology: a failure of smooth muscle fibers to relax, which can
cause a sphincter to remain closed and fail to open when needed
 Treatment:
Mechanical(pneumatic dilation)
Medical(botulinum toxin)
Surgery( heller myotomy )

18. botox
 Botulinum toxin A

19. Bioterrorism
 Many countries :
 Botulinum toxin as a biological weapon potential
bioterrorism threat
 A one-liter bottle of the toxin (type A ) could kill the entire
population of Earth

20. Thanks…