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: 3/23/2018 2:13:51 PM

Upcoming Events

2018 Pediatric Autism Symposium: Ensuring Long Term Outcomes in Children Birth to Five

This one day course will include educational sessions, case studies, and panel discussions that highlight evidence-based information for managing Autism Spectrum Disorders (ASD) and other related disabilities for children ages birth to 5. Learn more.

Register Online

From the Newsdesk

Pediatric Neurosurgeon and Chief of Surgery for Nicklaus Children’s Passes Away
The medical staff, employees and volunteers of Nicklaus Children’s Hospital mourn the passing of our esteemed Dr. Sanjiv Bhatia, a longstanding leader and dedicated champion for children with complex medical conditions and their families.
Medical Mission to Algeria Helps Children in Need of Spinal Surgeries
A group of children in Algeria who underwent complex surgeries as part of a 2016 U.S.-sponsored medical mission have many reasons to celebrate, and can do so with better movement of their limbs.


After Astry was born, her parents noticed that she wasn't progressing as babies typically do. She wasn't able to lift her head and she showed a lot of muscle weakness. Her pediatrician recommended they take her to see a neurologist, and so Astry's parents brought her to Nicklaus Children's Hospital.