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Vol. 24. Núm. 6.
Páginas 281-284 (agosto 2000)
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Vol. 24. Núm. 6.
Páginas 281-284 (agosto 2000)
Acceso a texto completo
Botulismo por herida: una causa de parálisis muscular generalizada
Wound Botulism: A Cause of Widespread Muscular Paralysis
Visitas
17888
S. Lasdica1, D. Fainstein, P. Casas, D. Maurizi
Servicio de Cuidados Intensivos.
M.A. Gertiser*, A. Czerniecki**
* Servicio de Neurofisiología.
** Servicio de Ortopedia y Traumatología. Hospital Privado del Sur. Argentina.
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El botulismo por herida es una enfermedad producida por el Clostridium botulinum, un bacilo grampositivo anaerobio estricto que se instaura a través de heridas desarrollándose en tejidos necróticos. Este microorganismo libera toxinasque actúan a nivel de las terminales sinápticas bloqueando la liberación del neurotransmisor, manifestándose clínicamente por una parálisis muscular descendente con compromiso de los nervios craneanos. El tratamiento de esta enfermedad consiste en cuidados de enfermería, cuidados de la vía aérea si el paciente se encuentra en asistencia respiratoria mecánica, y la administración de antibióticos y antitoxinas. La mortalidad es inferior al 10%, con persistencia de los síntomas que puede superar el año. La resolución total del déficit neurológico puede prolongarse durante meses a años. Pesentamos un caso de botulismo por herida con una revisión bibliográfica.

Palabras Clave:
botulismo
herida
parálisis neuromuscular

Wound botulism is a pathology caused by Clostridium botulinum, a grampositive bacillus strict anaerobic that enters through wounds being developed in necrotic tissue. This organism liberates toxins that act at sinaptic terminals blocking the liberation of the neurotransmisor, resulting in a descending muscular paralysis with inclusion of the cranial nerves.

The treatment consists on nursing care, care of the airway if the patient is in mechanical ventilation, and the administration of antibiotics and antitoxins. The mortality is lower than 10% with permanency of the symptoms over one year. The total resolution of the neurological deficit can take months to years. A case is presented with a bibliographical revision.

Key Words:
Wound botulism
neuromuscular paralysis
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Bibliografía
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Copyright © 2000. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
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