ABSTRACT
This manuscript reports a case of intestinal toxemia botulism in an adult with recently diagnosed metastatic colon cancer in whom botulism symptoms began 23 days after hospital admission. Representing the rarest form of botulism presentation in clinical practice, this infectious disease may have developed due to a cluster of predisposing factors that favored Clostridium botulinum colonization and the endogenous production of neurotoxins, among which are previous use of broad-spectrum antibiotics and colon changes related to the development of the neoplasia. This case highlights the importance of considering intestinal toxemia botulism in the differential diagnosis of a patient presenting with symmetrical descending flaccid paralysis, since immediate treatment with botulinum antitoxin may improve clinical outcomes.
Subject(s)
Botulism/diagnosis , Colonic Neoplasms/complications , Cross Infection/microbiology , Intestinal Diseases/microbiology , Toxemia/diagnosis , Botulism/complications , Fatal Outcome , Feces/microbiology , Humans , Male , Middle Aged , Toxemia/complicationsABSTRACT
Durante 27 anos, o diagnóstico clínico da doença de Alzheimer foi baseado nos critérios feitos, em 1984, pela National Institute of Neurological and Communicative Disorders and Strokes (NINCDS) e pelo Alzheimer?s Disease and Related Disorders Association (ADRDA). Contudo, com o passar dos anos, os avanços científicos permitiram melhor compreensão da sua fisiopatologia, bem como melhor entendimento sobre as outras formas de demência - que culminaram na necessidade de revisão dos antigos critérios. Por isso, em 2011 foram publicados quatro artigos com novas recomendações da NINCDS-ADRDA. As principais mudanças nas novas diretrizes envolvem a identificaçãode estágios não demenciais para doença e a incorporação dos biomarcadores.
For 27 years, the clinical diagnosis of Alzheimer?s disease was based on the criteria established in 1984 by the National Institute of Neurological and Communicative Disorders and Strokes (NINCDS) and the Alzheimer?s Disease and Related Disorders Association (ADRDA). However, over the years, scientific advances allowed a better understanding of its pathophysiology as well as about other forms of dementia - culminating in the need for a revision of the old criteria. Thus, in 2011, four articles with new recommendations from the NINCDS-ADRDA were published. The main changes in the new guidelines involve the identification of non-dementia stages for disease and incorporation of biomarkers.
