Detalle Publicación

Tétanos y botulismo

Título de la revista: MEDICINE (ELSEVIER)
ISSN: 0304-5412
Volumen: 12
Número: 51
Páginas: 2991 - 2999
Fecha de publicación: 2018
Introduction.: Tetanus and botulism constitute two life-threating infections caused by spore-forming bacteria, Clostridium tetani and Clostridium botulinum, respectively. Tetanus.: Tetanus is caused by tetanospasmine toxin, which inhibits GABA and glicine neurotransmitters release, causing spastic paralysis followed by respiratory failure and severe impairment of autonomic nervous system. Mortality rate is approximately 8-60%, therefore a prompt clinical diagnosis is essential to transfer the patient to intensive care unit and establish supportive care. In addition, the toxin must be neutralized with specific immunoglobulin, spasms must be controlled with benzodiazepines and cardiovascular instability must be managed with labetalol and magnesium sulphate. Botulism.: Botulism is caused by a thermolabile neurotoxin resulting in flaccid paralysis and respiratory failure, with an observed mortality of 5-10%. There are eight different toxins (A-H) produced by several Clostridium specie, responsible for botulism. Infection can occur following food poisoning with preformed toxin (food-borne botulism), by ingestion of food contaminated with Clostridium botulinum spores (infant botulism), by wound contamination or bacteria inhalation if used as a bioweapon. Early respiratory and airway support must be established together with additional measures (antitoxin and antibiotic).