Food poisonings

​1. Microbial Food Poisoning (Bacterial)

​🟦 Definition: Acute gastroenteritis after ingesting contaminated food, affecting one or more persons sharing the same food.

​🟥 Types (Appearance Time):

​Toxogenic: Symptoms appear in < 5 hours.

​Entero-Invasive: Symptoms appear in 12-18 hours.

​🟦 Foods to Note: Ham, sausage, dried meat, milk products, eggs. Streptococci spores/toxins are heat stable.

​🟥 Clinical Picture: Vomiting (early/profuse in toxogenic), Diarrhea (profuse, watery). Constitutional symptoms (Fever/Chills) are more common in invasive types.

​2. Botulism

​🟦 Cause: Acute food poisoning from toxins produced by Clostridium botulinum.

​🟥 Toxin: The most potent toxin known. Toxin is destroyed by heating at 100^{\circ}\text{C} for 15 minutes or by autoclave.

​🟦 Mechanism (Key): Toxin binds irreversibly to neuromuscular junction \rightarrow prevents Acetylcholine release \rightarrow paralysis. Toxin does not cross the blood-brain barrier.

​🟥 Clinical Picture (Food-Borne): Appears 12-36 hours post-ingestion. Descending symmetrical muscle weakness/paralysis. Mentality is unaffected. Death from respiratory paralysis or cardiac arrest without coma.

​Early/Cranial Nerves: Diplopia, blurred vision, ptosis, fixed pupils, dysphagia (swallowing), dry mouth/eyes, slurred speech.

​🟦 Specific Treatment: Antibotulism antitoxin (Heptavalent-equine). Human Botulism Immunoglobulin for infant botulism. Avoid Mg containing cathartics.

Favism (Genetic)

​🟥 Cause: Ingestion of fava beans/inhalation of pollen in patients with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency \rightarrow haemolysis.

​🟦 Symptoms: Jaundice, fever, dark urine (hemoglobinuria), pallor. Appear 1-2 days after ingestion.

​🟥 Treatment: Blood transfusion, Corticosteroids, and Alkalinization of urine (with Sodium Bicarbonate) to protect kidneys.