Botulism is 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.
Botulism is a paralytic illness caused by the neurotoxin produced by Clostridium botulinum. C botulinum is a large, gram-positive anaerobic bacillus that primarily exists in the form of a spore until environmental conditions suitable for germination arise.
Clinical symptoms result from the entry of botulinum toxin into the systemic circulation.
History and exam
- feeding difficulties in infants
- weakened cry in infants
- urinary retention
- dry mouth and throat
- postural hypotension
- gastrointestinal illness
- diminished or absent deep tendon reflexes
- absence of fever
- respiratory dysfunction
- pupillary dilation
Linda S. Nield, MD, FAAP
Professor of Pediatrics and Medical Education
West Virginia University School of Medicine
LSN is an author of a reference cited in this topic.
Dr Linda S. Nield would like to gratefully acknowledge Dr Thomas P. Bleck, Dr Aimee Hodowanec, Dr Pavani Reddy, and Dr Teresa Zembower, previous contributors to this topic.
TPB, AH, PR, and TZ declare that they have no competing interests.
Fiona Cooke, MA, PhD, MSc, FRCPath, MRCP, DTM&H
Research Fellow and Medical Microbiologist
Wellcome Trust Sanger Institute
Department of Microbiology
FC declares that she has no competing interests.
Christopher D. Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
CDH declares that he has no competing interests.
William A. Petri, Jr, MD, PhD, FACP
Chief and Professor of Medicine
Division of Infectious Diseases and International Health
University of Virginia Health System
WAP declares that he has no competing interests.
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