Signs of botulism, as it manifests itself in humans
One of the most dangerous infectious diseases is botulism.
It is characterized by the defeat of the nervous system, namely neurons of the oblong, spinal cord and cranial nerves with the appearance of specific symptoms.
It should be noted that the signs of botulism appear in humans under the influence of botulinum toxin, while the bacterium itself or its spores do no harm to the body.
How botulism manifests in humans
The incubation period is quite short - from several hours to five days. The onset of the disease is gradual with a tendency to increase all the symptoms. The first signs of botulism can be called gastrointestinal disorders.
Lesion of the gastrointestinal tract
Getting infected with food in the human body, botulinum toxin causes:
- stomach ache;
In comparison with other intestinal infections, these symptoms are not significant and are only the beginning of the disease.
As the botulinum toxin is absorbed into the blood, a paresis (sharp weakening of the motor) of the stomach and intestines develops with the appearance of bloating, belching, feelings of overflow, stool and gas retention. Gradually, the ingestion of solid and then liquid food is broken. Patients describe their condition as a "lump in the throat". The reason is the same - paresis of the muscles of the pharynx.
At the initial stage, the disease is very difficult to distinguish from other infections that occur with digestive disorders. After several hours, neurologic symptoms appear, which allows you to suspect the signs of botulism in humans.
They develop immediately or after a decrease in vomiting and abdominal pain. Botulinum toxin has a pronounced tropicity (affinity, preferability) to the nervous system, so neurological disorders come to the fore and are an undeniable confirmation of the diagnosis.
The defeat of the third pair of cranial nerves (oculomotor nerve) is manifested by the following symptoms:
- diplopia (double vision);
- ptosis (omission of the upper eyelid, inability to open eyes independently);
- violation of convergence (patients can not fix sight on the tip of the nose);
- dilated pupils (sometimes uneven-anisocoria);
- ophthalmoplegic syndrome (horizontal and vertical nystagmus);
- sensation of "swaddling" or "netting" before the eyes, vagueness of objects;
- possibly strabismus.
The above symptoms are caused by a violation of the movement of the eye muscles due to the defeat of the neurons of the oculomotor nerve (N.oculomotorius) by botulinum toxin.
It manifests itself in the form of bulbar syndrome (paralysis), in which 3 pairs of cranial nerves suffer. The glossopharyngeal, wandering and sublingual nerves are responsible for swallowing, movement of the tongue, palatine reflexes.
With the loss of the functions of these nerves, an extremely dangerous condition for the patient's life arises with the following symptoms:
- dysarthria (speech disorders, inability to speak with full understanding of what is written and what happens);
- Dysphagia (impaired swallowing of food, saliva and water due to paralysis of the muscles of the palate, epiglottis, tongue);
- dry mouth with a sharp decrease in salivation.
The voice of such patients becomes weak, very quiet, speech is illegible. As the condition deteriorates, there is aphonia (complete loss of voice) due to paralysis of the vocal cords. People are almost deprived of the opportunity to eat due to a violation of swallowing, the saliva flows out, the mouth is ajar. When trying to drink fluid, patients risk choking, which can lead to the onset of aspiration pneumonia.
Very often affected intercostal and diaphragmatic muscles responsible for the processes of inspiration and exhalation. When they are affected, breathing is disrupted, becomes superficial, frequent, and in the worst case, complete paralysis of respiration with its stop can occur. The appearance of such signs dictates the need for immediate transfer of the patient to mechanical ventilation (artificial ventilation of the lungs).
Movement is also disturbed in other muscle groups. Patients can not raise their head due to weakness of the neck muscles, weakness in the upper extremities grows. The main distinguishing feature of botulism poisoning is the full preservation of sensitivity along with motor impairments.
Complications of botulism
- Quite often, various complications are attached to the first signs of botulism in adults. In the first place in terms of frequency of occurrence are purulent bronchitis, aspiration pneumonia, atelectasis of the lung (collapse with violation of respiratory function). Related conditions are associated with the defeat of the muscles of the pharynx, palate and tongue, the inability to swallow and spit out saliva.
- A small number of people can develop acute respiratory failure, characterized by increased dyspnea and excitation of the patient, forced posture, bluish staining of the skin due to lack of oxygen in the blood. Acute ventilation failure occurs for two reasons: a paresis of the respiratory muscles with an inability to inhale and aspiration of saliva or vomiting due to swallowing disorders. If untimely assistance is given, the patient dies of suffocation.
- The disorder of vision does not cause any complications and as it recovers completely disappears, leading to a complete restoration of the functions of the visual analyzer.
- It rarely occurs purulent parotitis (inflammation of the salivary glands). It is believed that this disease is associated with an ascending infection and a general weakening of immunity against the background of botulism.
- The expressed respiratory insufficiency can lead to an increase in the volume of the heart, the expansion of the atria and ventricles, tachycardia, a decrease in arterial pressure, which is the cause of the development of acute heart failure.
Thus, the clinical picture of the disease, although diverse, is very specific. Diagnosis of botulism does not cause particular difficulties for a doctor of any specialty even in the absence of laboratory and instrumental examinations.