Also known as: Botulinum toxin, botulinus intoxication, food poisoning.

What is botulism?

Botulism is an illness caused by a toxin produced by bacteria called Clostridium botulinum that normally live in the soil, dust and cooked agricultural products. There are 3 clinical presentations - foodborne with food poisoning, wound botulism and infant botulism. Botulinum toxin is the most potent toxin known and can cause death in tiny amounts.

What causes botulism?

Food-borne botulism results from food contamination where the method of food preparation (e.g. home canning) creates an environment in which the bacterium can produce its toxin. Toxin ingestion results in food poisoning.

Infected wounds are another area where the environment is good for clostridium botulinum bacteria to grow and produce its toxin.

Infant botulism (infants < 1 year of age, are the only age group that can get botulism from eating spores because the bacteria are not killed by gut mechanisms - less acid in their stomachs compared to older children, and because their immune system is not fully developed yet) can arise from ingesting unprepared foods like honey.

What are the symptoms of botulism?

Food botulism usually begins 18-36 hours after ingestion and results in nausea, vomiting and diarrhea (which goes on to constipation). Muscle movement is affected next (frequently blurred  “double vision”, difficulty swallowing, dry mouth, slurred speech ) followed by muscle paralysis which can lead to breathing difficulties (plus other symptoms) and death.

Wound botulism (the least common type) presents 4-14 days after a potentially contaminated wound, with muscle weakness and fever.

The incubation period for infant (usually 2-4 months of age) botulism is 2-4 weeks. Constipation is frequently the first symptom, with poor a weak cry, poor sucking/ feeding, droopy head and eyelids, facial and generalized  muscle weakness (and poor breathing requiring artificial ventilation) are usual.

What are botulism care options?

Supportive care (particularly ventilation support) is critical; antitoxin administration, intravenous botulism immune globulin (for infants), intravenous fluids and antibiotics for wound botulism (and surgical removal of infected material) are usual therapies.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: September 27, 2019 04:27 PM

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