Summary

• A paralytic illness caused by the neurotoxin produced by Clostridium botulinum, which is a large, gram-positive anaerobic bacillus.
• Clostridium botulinum primarily exists in the form of a subterminal spore until environmental conditions suitable for germination arise.
• Clinical symptoms result from the entry of botulinum toxin into the systemic circulation.
• Toxin ingestion leads to a clinical syndrome characterised by cranial nerve palsies; oculobulbar weakness; and descending, symmetrical flaccid paralysis in the absence of fever. Affected patients do not complain of sensory deficits.
• The diagnosis of botulism is a clinical one, confirmed by the detection of toxin in clinical samples.
• Treatment relies on a combination of aggressive supportive care and the swift administration of antitoxin in suspected cases.