Botulism

ABSTRACT

Botulism is a life threatening disorder caused by a neurotoxin produced from the anaerobic, spore-forming bacterium Clostridium botulinum. There are seven antigenically distinct types of botulinum neurotoxins (types A through G), and the human botulism is primarily caused by toxin types A, B, and E. Four clinical forms of botulism occur in humans foodborne botulism, wound botulism, infant botulism, and adult infectious botulism. Botulism is characterized by symmetric, descending, flaccid paralysis of motor and autonomic nerves, usually beginning with the cranial nerves. Dry mouth, blurred vision, and diplopia are usually the earliest neurologic symptoms. Botulism should be suspected in a patient with an acute onset of gastrointestinal, autonomic, and cranial nerve dysfunction. Confirmation of the diagnosis of botulism depends on the detection of the toxin or the organism in the patient. The most reliable method for the detection of the toxin is the mouse inoculation test. The mainstay of treatment for severe botulism is supportive therapy with mechanical ventilation. The administration of antitoxin is the only specific pharmacologic treatment available for botulism. Botulism is a rare but potentially fatal illness, so timely recognition of the clinical symptoms plays an important role in decreasing the mortality rate.