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DOI: 10.1055/s-0042-1758651
Botulism in the Brazilian Amazon: a life-threatening disease in a neglected population
Botulismo na Amazônia brasileira: uma doença fatal em uma população negligenciada
Abstract
Background Botulism is a rare and potentially fatal neuroparalytic syndrome caused by the gram-positive anaerobe spore-forming bacterium Clostridium botulinum. The microorganism produces a neurotoxin that inhibits the presynaptic release of acetylcholine at the neuromuscular junction, clinically leading to a myasthenic syndrome.
Objective To describe the recent outbreak of botulism cases and its demographic, clinical, and laboratory characteristics.
Methods We report 4 patients with botulism in the recent outbreak occurred between 2017 and 2019 in the state of Amazon.
Results Out of four patients with botulism, three contracted it from eating contaminated food and one had wound botulism. We emphasize the excellent clinical outcome of the different disease presentations in our case series.
Conclusion The temporal proximity of these reports may suggest a new rise in the number of cases in the upcoming years. A possible hypothesis is that the rarity of the disease decreased the awareness regarding the primary prevention or even a diagnosis by an untrained physician.
Resumo
Antecedentes O botulismo é uma síndrome neuroparalítica rara e potencialmente fatal causada pela bactéria anaeróbia gram-positiva formadora de esporos Clostridium botulinum. O microrganismo produz uma neurotoxina que inibe a liberação pré-sináptica de acetilcolina na junção neuromuscular, levando clinicamente a uma síndrome miastênica.
Objetivo Descrever o recente surto de casos de botulismo e suas características demográficas, clínicas e laboratoriais.
Métodos Relatamos quatro pacientes com botulismo em surto recente ocorrido entre 2017 e 2019 no estado do Amazonas.
Resultados Dos quatro pacientes com botulismo, três o contraíram devido ao consumo de alimento contaminado e um por ferimento. Enfatizamos o excelente resultado clínico das diferentes apresentações da doença em nossa série de casos.
Conclusão A proximidade temporal dessas notificações pode sugerir um novo aumento no número de casos nos próximos anos. Uma possível hipótese é que a raridade da doença diminuiu a conscientização quanto à prevenção primária ou mesmo ao diagnóstico por médico destreinado.
Authors' Contributions:
LMO, MRAB: acquisition of data and manuscript review; DBG, LCRC: drafting of the final manuscript and manuscript review; PVSF: drafting of the initial and final manuscripts, acquisition of data, literature review, and manuscript review.
Publication History
Received: 29 November 2021
Accepted: 16 March 2022
Article published online:
29 December 2022
© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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