Signs of botulism as it appears in humans
One of the most dangerous infectious diseases is botulism.
It is characterized by damage to the nervous system, namely the neurons of the medulla oblongata, the spinal cord and cranial nerves with the appearance of specific symptoms.
It is worth noting that signs of botulism appear in humans under the influence of botulinum toxin, while the bacterium itself or its spores do not bring any harm to the body.
How is botulism in humans
The incubation period is rather 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 include gastrointestinal disorders.
Getting into the human body with infected food, botulinum toxin causes:
- stomach ache;
Compared with other intestinal infections, these symptoms are mild and are only the beginning of the disease.
As botulinum toxin is absorbed into the blood, paresis (a sharp weakening of motility) of the stomach and intestines develops with swelling, eructation, feelings of overflow, delayed stools and gas. The ingestion of solid and then liquid foods is gradually disrupted. Patients describe their condition as "a lump in the throat." The reason is the same - paresis of the throat muscles.
At the initial stage of the disease is very difficult to distinguish from other infections that occur with indigestion. A few hours later, neurological symptoms appear, which makes it possible to suspect the symptoms of botulism in a person.
They develop immediately or after the reduction of vomiting and abdominal pain. Toxin botulism has a pronounced tropism (affinity, preference) to the nervous system, so neurological disorders come to the fore and are an indisputable 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, the inability to open their eyes)
- violation of convergence (patients can not fix the view on the tip of the nose);
- dilated pupils (sometimes uneven — anisocoria);
- ophthalmoplegic syndrome (horizontal and vertical nystagmus);
- the feeling of "veil" or "grid" before the eyes, the vagueness of objects;
- possible squint.
The above symptoms are due to impaired movement of the eye muscles due to ocular motor nerve neurons (N.oculomotorius) damage by botulinum toxin.
Manifested in the form of bulbar syndrome (paralysis), in which 3 pairs of cranial nerves are affected. The glossopharyngeal, vagus, and hypoglossal nerves are responsible for swallowing, movement of the tongue, and palatal reflexes.
With the loss of the functions of these nerves, an extremely life-threatening condition arises with the following symptoms:
- dysarthria (speech disorders, inability to speak with a full understanding of what is written and what is happening);
- dysphagia (a violation of swallowing 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 in such patients becomes weak, very quiet, speech is illegible. As the condition worsens, there is aphonia (complete loss of voice) due to paralysis of the vocal cords. People are almost unable to eat because of a violation of swallowing, saliva flows out, the mouth is ajar. When trying to drink a liquid, patients risk choking, which can lead to aspiration pneumonia.
Muscle movement disorder
Very often intercostal and diaphragmatic muscles, which are responsible for the processes of inhalation and exhalation, are affected. When they are damaged, respiration is disturbed, becomes superficial, frequent, and in the worst case, complete respiratory paralysis can occur with its stopping. The appearance of such signs dictates the need for an immediate transfer of the patient to mechanical ventilation (artificial lung ventilation).
Movement in other muscle groups is also impaired. Patients cannot lift their heads due to weakness of the neck muscles, weakness increases in the upper limbs. The main hallmark of botulism poisoning is the complete preservation of sensitivity along with motor disorders.
Complications of botulism
- Quite often, the first signs of botulism in adults are joined by various complications. In the first place in terms of incidence are purulent bronchitis, aspiration pneumonia, lung atelectasis (collapse with impaired respiratory function). Similar conditions are associated with damage to the muscles of the pharynx, palate and tongue, the impossibility of swallowing and spitting saliva.
- A small number of people may develop acute respiratory failure, characterized by an increase in shortness of breath and excitement 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: paresis of the respiratory muscles with inability to inhale and aspiration of saliva or vomiting due to a violation of swallowing. In case of untimely care, the patient dies from asphyxiation.
- The disorder of vision does not cause any complications and, as the patient recovers, disappears without a trace, leading to the complete restoration of the functions of the visual analyzer.
- Rarely there is purulent parotitis (inflammation of the salivary glands). It is believed that this disease is associated with ascending infection and a general weakening of the immune system in the background of botulism.
- Severe respiratory failure can lead to an increase in heart volume, expansion of the atria and ventricles, tachycardia, a decrease in blood pressure, and cause the development of acute heart failure.
Thus, the clinical picture of the disease, although diverse, is very specific. Diagnosis of botulism does not cause any particular difficulties for the doctor of any specialty, even in the absence of laboratory and instrumental examinations.