title: Signs and symptoms predictive of respiratory failure in patients with foodborne botulism in Thailand.
abstract: We conducted a clinical study of 137 patients with home-canned bamboo shoot botulism at Nan Hospital, northern Thailand. The median age of the patients was 44 years (range = 14-74 years) and 36.2% were male. The median incubation period was 2 days (range = 1-8 days). Forty-three patients (31.4%) developed respiratory failure, but there were no deaths. Patients who did not have either nausea or vomiting and did not have urinary retention that required Foley catheterization was less likely to develop respiratory failure. This clinical predictor rule had a sensitivity of 75.5% and a specificity of 90.7%. The clinical syndrome most predictive of respiratory failure was nausea or vomiting and any cranial neuropathy with urinary retention or difficulty swallowing. This clinical syndrome had a sensitivity of 69.8% and a specificity of 93.6%. These clinical characteristics could help triage large numbers of patient in the event of a future outbreak.
authors: Department of Medicine, Nan Hospital, 1 Worawichai Road, Amphur Mueng, Nan 55000, Thailand. manas wongtanate@hotmail.com
authors: Manas
authors: M
authors: Wongtanate
authors: Niwatchai
authors: N
authors: Sucharitchan
authors: Kanit
authors: K
authors: Tantisiriwit
authors: Petchdee
authors: P
authors: Oranrigsupak
authors: Aphinya
authors: A
authors: Chuesuwan
authors: Sukumal
authors: S
authors: Toykeaw
authors: Yupin
authors: Y
authors: Suputtamongkol
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000378:metabolism* / Q000506:poisoning; D001906:Botulism / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D003014:Clostridium botulinum / Q000254:growth & development*; D003389:Cranial Nerve Diseases; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D016055:Urinary Retention
chemical_list: D019274:Botulinum Toxins, Type A