Botulism differential diagnosis: Difference between revisions
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==Differentiating Botulism from other Diseases== | ==Differentiating Botulism from other Diseases== | ||
Botulism must be differentiated from neuromuscular disorders that present with muscle weakness and flaccidity, such as: | Botulism must be differentiated from neuromuscular disorders that present with muscle weakness and flaccidity, such as: | ||
{| | {| | ||
|-style="background: #4479BA; color: #FFFFFF; text-align: center;" | |-style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
! rowspan="2" |<small>Diseases</small> | ! rowspan="2" |<small>Diseases</small> | ||
! colspan=" | ! colspan="11" |<small>History and Physical | ||
! colspan="3" |<small>Diagnostic tests</small> | ! colspan="3" |<small>Diagnostic tests</small> | ||
! rowspan="2" |<small>Other Findings</small> | ! rowspan="2" |<small>Other Findings</small> | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
!<small>Headache</small> | !<small>Headache</small> | ||
! | !Loss of Consciousness | ||
!<small> | !<small>Muscle pain</small> | ||
!<small>Abnormal sensory</small> | !<small>Abnormal sensory</small> | ||
!<small>Motor Deficit</small> | !<small>Motor Deficit</small> | ||
Line 28: | Line 22: | ||
!<small>Speech difficulty</small> | !<small>Speech difficulty</small> | ||
!<small>Gait abnormality</small> | !<small>Gait abnormality</small> | ||
!<small>Cranial nerves</small> | !<small>Cranial nerves</small>Involvement | ||
!Unilateral (UL) | |||
or Bilateral (BL) | |||
!Onset | |||
!<small>CT /MRI</small> | !<small>CT /MRI</small> | ||
!<small>CSF Findings</small> | !<small>CSF Findings</small> | ||
!<small>Gold standard test</small> | !<small>Gold standard test</small> | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" | Adult Botulism | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | |style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | |style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
Line 43: | Line 40: | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | |style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | |style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
| | |||
|style="background: #F5F5F5; padding: 5px text-align:center" |[[Weight loss]], [[fatigue]] | |style="background: #F5F5F5; padding: 5px text-align:center" |[[Weight loss]], [[fatigue]] | ||
|style="background: #F5F5F5; padding: 5px; text-align:center"| + | |style="background: #F5F5F5; padding: 5px; text-align:center"| + | ||
Line 49: | Line 47: | ||
|style="background: #F5F5F5; padding: 5px;" |[[Cachexia]], gradual progression of symptoms | |style="background: #F5F5F5; padding: 5px;" |[[Cachexia]], gradual progression of symptoms | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" | | |Infant Botulism | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | | ||
|style="background: #F5F5F5; padding: 5px text-align:center" |[[Hypertension]] | | | ||
|style="background: #F5F5F5; padding: 5px; text-align:center" | + | | | ||
| | |||
| | |||
| | |||
| | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Stroke | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | |||
| | |||
| style="background: #F5F5F5; padding: 5px text-align:center" |[[Hypertension]] | |||
| style="background: #F5F5F5; padding: 5px; text-align:center" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
|style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{cite journal| author=Birenbaum D, Bancroft LW, Felsberg GJ| title=Imaging in acute stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 1 | pages= 67-76 | pmid=21694755 | doi= | pmc=3088377 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694755 }}</ref><ref name="pmid21807345">{{cite journal| author=DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF et al.| title=ACR Appropriateness Criteria® on cerebrovascular disease. | journal=J Am Coll Radiol | year= 2011 | volume= 8 | issue= 8 | pages= 532-8 | pmid=21807345 | doi=10.1016/j.jacr.2011.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21807345 }}</ref> | | style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{cite journal| author=Birenbaum D, Bancroft LW, Felsberg GJ| title=Imaging in acute stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 1 | pages= 67-76 | pmid=21694755 | doi= | pmc=3088377 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694755 }}</ref><ref name="pmid21807345">{{cite journal| author=DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF et al.| title=ACR Appropriateness Criteria® on cerebrovascular disease. | journal=J Am Coll Radiol | year= 2011 | volume= 8 | issue= 8 | pages= 532-8 | pmid=21807345 | doi=10.1016/j.jacr.2011.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21807345 }}</ref> | ||
|style="background: #F5F5F5; padding: 5px;" |[[Neck stiffness]] | | style="background: #F5F5F5; padding: 5px;" |[[Neck stiffness]] | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" | Myasthenia gravis | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" |[[Trauma]], fall | | | ||
|style="background: #F5F5F5; padding: 5px; text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" |[[Trauma]], fall | ||
|style="background: #F5F5F5; padding: 5px;" |Xanthochromia<ref name="pmid1198628">{{cite journal| author=Lee MC, Heaney LM, Jacobson RL, Klassen AC| title=Cerebrospinal fluid in cerebral hemorrhage and infarction. | journal=Stroke | year= 1975 | volume= 6 | issue= 6 | pages= 638-41 | pmid=1198628 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1198628 }}</ref> | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{cite journal| author=Birenbaum D, Bancroft LW, Felsberg GJ| title=Imaging in acute stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 1 | pages= 67-76 | pmid=21694755 | doi= | pmc=3088377 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694755 }}</ref><ref name="pmid21807345">{{cite journal| author=DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF et al.| title=ACR Appropriateness Criteria® on cerebrovascular disease. | journal=J Am Coll Radiol | year= 2011 | volume= 8 | issue= 8 | pages= 532-8 | pmid=21807345 | doi=10.1016/j.jacr.2011.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21807345 }}</ref> | | style="background: #F5F5F5; padding: 5px;" |Xanthochromia<ref name="pmid1198628">{{cite journal| author=Lee MC, Heaney LM, Jacobson RL, Klassen AC| title=Cerebrospinal fluid in cerebral hemorrhage and infarction. | journal=Stroke | year= 1975 | volume= 6 | issue= 6 | pages= 638-41 | pmid=1198628 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1198628 }}</ref> | ||
|style="background: #F5F5F5; padding: 5px;" |[[Confusion]], [[dizziness]], [[nausea]], [[vomiting]] | | style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{cite journal| author=Birenbaum D, Bancroft LW, Felsberg GJ| title=Imaging in acute stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 1 | pages= 67-76 | pmid=21694755 | doi= | pmc=3088377 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694755 }}</ref><ref name="pmid21807345">{{cite journal| author=DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF et al.| title=ACR Appropriateness Criteria® on cerebrovascular disease. | journal=J Am Coll Radiol | year= 2011 | volume= 8 | issue= 8 | pages= 532-8 | pmid=21807345 | doi=10.1016/j.jacr.2011.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21807345 }}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" |[[Confusion]], [[dizziness]], [[nausea]], [[vomiting]] | |||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neurosyphilis]]<ref name="pmid22482824">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824 }} </ref><ref name="pmid24365430">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neurosyphilis]]<ref name="pmid22482824">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824 }} </ref><ref name="pmid24365430">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref> | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" |[[Sexually transmitted disease|STI]]<nowiki/>s | | | ||
|style="background: #F5F5F5; padding: 5px; text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" |[[Sexually transmitted disease|STI]]<nowiki/>s | ||
|style="background: #F5F5F5; padding: 5px;" |'''↑''' [[Leukocytes]] and [[protein]] | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px;" |CSF [[VDRL]]-specifc | | style="background: #F5F5F5; padding: 5px;" |'''↑''' [[Leukocytes]] and [[protein]] | ||
| style="background: #F5F5F5; padding: 5px;" |CSF [[VDRL]]-specifc | |||
CSF FTA-Ab -sensitive<ref name="pmid22421697">{{cite journal| author=Ho EL, Marra CM| title=Treponemal tests for neurosyphilis--less accurate than what we thought? | journal=Sex Transm Dis | year= 2012 | volume= 39 | issue= 4 | pages= 298-9 | pmid=22421697 | doi=10.1097/OLQ.0b013e31824ee574 | pmc=3746559 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22421697 }}</ref> | CSF FTA-Ab -sensitive<ref name="pmid22421697">{{cite journal| author=Ho EL, Marra CM| title=Treponemal tests for neurosyphilis--less accurate than what we thought? | journal=Sex Transm Dis | year= 2012 | volume= 39 | issue= 4 | pages= 298-9 | pmid=22421697 | doi=10.1097/OLQ.0b013e31824ee574 | pmc=3746559 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22421697 }}</ref> | ||
|style="background: #F5F5F5; padding: 5px;" |[[Blindness]], [[confusion]], [[depression]], | | style="background: #F5F5F5; padding: 5px;" |[[Blindness]], [[confusion]], [[depression]], | ||
Abnormal [[gait]] | Abnormal [[gait]] | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Eaton Lambert Syndrome | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" |Family history of [[migraine]] | | | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Family history of [[migraine]] | |||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
|style="background: #F5F5F5; padding: 5px;" |Clinical assesment | | style="background: #F5F5F5; padding: 5px;" |Clinical assesment | ||
|style="background: #F5F5F5; padding: 5px;" |Presence of aura, [[nausea]], [[vomiting | | style="background: #F5F5F5; padding: 5px;" |Presence of aura, [[nausea]], [[vomiting]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]] exacerbation | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]] exacerbation | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px text-align:center" | - | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px text-align:center" | + | ||
|style="background: #F5F5F5; padding: 5px text-align:center" |History of relapses and remissions | | | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |History of relapses and remissions | |||
| style="background: #F5F5F5; padding: 5px; text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |'''↑''' CSF IgG levels | | style="background: #F5F5F5; padding: 5px; text-align:center" |'''↑''' CSF IgG levels | ||
Line 250: | Line 153: | ||
| style="background: #F5F5F5; padding: 5px;" |[[Blurred vision|Blurry vision]], [[urinary incontinence]], [[fatigue]] | | style="background: #F5F5F5; padding: 5px;" |[[Blurred vision|Blurry vision]], [[urinary incontinence]], [[fatigue]] | ||
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Revision as of 12:47, 22 May 2017
Botulism Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Botulism differential diagnosis On the Web |
American Roentgen Ray Society Images of Botulism differential diagnosis |
Risk calculators and risk factors for Botulism differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.
Overview
Botulism must be differentiated from neuromuscular disorders that present with muscle weakness and flaccidity.
Differentiating Botulism from other Diseases
Botulism must be differentiated from neuromuscular disorders that present with muscle weakness and flaccidity, such as:
Diseases | History and Physical | Diagnostic tests | Other Findings | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Headache | Loss of Consciousness | Muscle pain | Abnormal sensory | Motor Deficit | Sensory deficit | Speech difficulty | Gait abnormality | Cranial nervesInvolvement | Unilateral (UL)
or Bilateral (BL) |
Onset | CT /MRI | CSF Findings | Gold standard test | ||
Adult Botulism | + | - | - | - | + | + | + | - | + | Weight loss, fatigue | + | Cancer cells[1] | MRI | Cachexia, gradual progression of symptoms | |
Infant Botulism | |||||||||||||||
Stroke | + | + | + | + | + | + | + | + | - | Hypertension | + | - | CT scan without contrast[2][3] | Neck stiffness | |
Myasthenia gravis | + | + | + | + | + | - | - | - | + | Trauma, fall | + | Xanthochromia[4] | CT scan without contrast[2][3] | Confusion, dizziness, nausea, vomiting | |
Neurosyphilis[5][6] | + | - | + | + | + | + | - | + | - | STIs | + | ↑ Leukocytes and protein | CSF VDRL-specifc
CSF FTA-Ab -sensitive[7] |
Blindness, confusion, depression,
Abnormal gait | |
Eaton Lambert Syndrome | + | - | + | + | - | - | + | - | - | Family history of migraine | - | - | Clinical assesment | Presence of aura, nausea, vomiting | |
Multiple sclerosis exacerbation | - | - | + | + | - | + | + | + | + | History of relapses and remissions | + | ↑ CSF IgG levels
(monoclonal bands) |
Clinical assesment and MRI [8] | Blurry vision, urinary incontinence, fatigue | |
References
- ↑ Weston CL, Glantz MJ, Connor JR (2011). "Detection of cancer cells in the cerebrospinal fluid: current methods and future directions". Fluids Barriers CNS. 8 (1): 14. doi:10.1186/2045-8118-8-14. PMC 3059292. PMID 21371327.
- ↑ 2.0 2.1 Birenbaum D, Bancroft LW, Felsberg GJ (2011). "Imaging in acute stroke". West J Emerg Med. 12 (1): 67–76. PMC 3088377. PMID 21694755.
- ↑ 3.0 3.1 DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF; et al. (2011). "ACR Appropriateness Criteria® on cerebrovascular disease". J Am Coll Radiol. 8 (8): 532–8. doi:10.1016/j.jacr.2011.05.010. PMID 21807345.
- ↑ Lee MC, Heaney LM, Jacobson RL, Klassen AC (1975). "Cerebrospinal fluid in cerebral hemorrhage and infarction". Stroke. 6 (6): 638–41. PMID 1198628.
- ↑ Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.
- ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.
- ↑ Ho EL, Marra CM (2012). "Treponemal tests for neurosyphilis--less accurate than what we thought?". Sex Transm Dis. 39 (4): 298–9. doi:10.1097/OLQ.0b013e31824ee574. PMC 3746559. PMID 22421697.
- ↑ Giang DW, Grow VM, Mooney C, Mushlin AI, Goodman AD, Mattson DH; et al. (1994). "Clinical diagnosis of multiple sclerosis. The impact of magnetic resonance imaging and ancillary testing. Rochester-Toronto Magnetic Resonance Study Group". Arch Neurol. 51 (1): 61–6. PMID 8274111.