Botulism is caused by a paralytic neurotoxin produced by the anaerobic, spore-forming bacterium Clostridium botulinum. It is characterized clinically by a symmetric, descending paralysis often preceded by gastrointestinal manifestations and cranial nerve involvement. Respiratory muscle paralysis can be fatal unless mechanical ventilation is instituted. Ancillary testing can confirm the diagnosis but does not guide early treatment. The standard dose is one vial per patient, and is beneficial if administered early in the course of illness.
Botulinum toxin acts by blocking release of acetylcholine from the neuromuscular junction.
Foodborne botulism and infant botulism are the most common forms of the disease. Recently, the incidence of wound botulism has been increasing in the United States, especially on the West Coast among users of black tar heroin. Click here for the entire text of this article. The Centers for Disease Control and Prevention lists its case definitions of various forms of botulism. It is not a substitute for careful analysis of the original literature, and neither provides nor is intended to provide the basis for patient evaluation or treatment.