After Consuming Alcohol With Raw Beef, a Man Has Seizure, Pain

Aneesh Basheer, MD


December 05, 2022

In high-income countries, Clostridium perfringens infection produces watery diarrhea, although it is also well known for causing traumatic gas gangrene.[11] The disease is toxin-mediated and is usually acquired from consumption of undercooked or reheated meat. Type A strains are often associated with foodborne outbreaks of diarrhea that resolve in a few days. Fever and vomiting are usually not present. However, type C strains may manifest with blood in the stools as a result of hemorrhagic necrosis of the jejunum (also known as pigbel).[12,13] This type of disease is usually seen in resource-limited countries after ingestion of contaminated pork. As in patients with gastrointestinal anthrax, abdominal distention along with thickened and dilated bowel loops may occur in those with severe pigbel. The lack of fever and neurologic manifestations distinguishes this uncommon entity from gastrointestinal anthrax. The diagnosis is typically made by isolation of gram-positive bacilli from stool cultures under anaerobic conditions. Colonies may show a double zone of hemolysis on blood agar and produce precipitate in egg yolk agar.

Botulism is caused by the gram-positive bacillus Clostridium botulinum. The disease may occur in three forms: infant, foodborne, and wound botulism. Foodborne botulism presents with the acute onset of nausea, vomiting, and diarrhea, which are often accompanied by cramping abdominal pain. In some cases, the incubation period may be longer. The disease is caused by the consumption of food contaminated by preformed botulinum toxin, including canned fruits, vegetables, and fish.[14] Blood in the stools and fever are not observed. Neurologic involvement in the form of cranial nerve palsies and descending weakness may occur after the gastrointestinal manifestations.[15] However, seizures, meningitis, and parenchymal hemorrhages are not typical features, nor is ascites or gastrointestinal hemorrhage. Detection of the toxin from serum, stool, or vomitus is the most common method of diagnosis. Isolation of bacteria is best done from C botulinum isolation agar on fecal samples.


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