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Five days after sustaining a compound fracture of his right arm, this 14-year-old boy noticed that he had blurred vision. Four days later, he could not swallow, move his lips, or protrude his tongue. Other findings included bilateral total ophthalmoplegia with ptosis (left) and dilated, fixed pupils (right). When symmetric, descending cranial nerve paralysis develops four to 14 days after an open injury and spares mental and sensory function, think of wound botulism. 

Author Herbert L. Fred wikimedia commons
https://commons.wikimedia.org/wiki/File:Botulism1and2.JPG

Wound botulism involvement of compound fracture of right arm. 14-year-old boy fractured his right ulna and radius and subsequently developed wound botulism. 

Author CDC 



https://commons.wikimedia.org/wiki/File:Wound_botulism_involvement_of_compound_fracture,_right_arm.jp

Clostridium botulinum

  • General information

    • the following information is not yet verified
      Taxonomy
      Family: Clostridiaceae

      Natural habitats
      Spores are widely distributed in soil and aquatic habitats

      Clinical significance
      They are the cause of the rare but frequently fatal illness known as botulism and which is characterized by weakness, trouble seeing, trouble speaking and flaccid paralysis.

      Botulism
      Occur in a few different ways.

      Foodborne botulism, happens when food containing the toxin is eaten.

      Infant botulism, happens when the bacteria develops in the testiness and releases toxin.
      This only happens in children less than 6 months of age as after that protective mechanisms develop.

      Wound botulism is found most often among those who inject street drugs

      It is not passed directly between people.

  • Gram stain

    • the following information is not yet verified
      Gram positive rods,

      0.6-2.4 x 1.6-22.0 µm,

      which are often negatively stained, and free spores

      Spores oval / subterminal
      Swelling of the cell positive

  • Culture characteristics

    • the following information is not yet verified

      Obligate anaerobic

      BBAØ
      4 types of colony morphologies

      Colonies are 2-6 mm, β-hemolytic (variable), flat to raised, translucent to semi opaque, gray, circular to irregular, scalloped or rhizoid margin, often with a mottled or crystalline internal structure.

  • Characteristics

  • References


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