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Definition

Botulism is a rare, but life-threatening illness. It affects the nerves. It needs to be treated right away.

Causes

Botulism is caused by bacteria that makes toxins. It can cause a type of food poisoning. Rarely, the bacteria enter the blood through wounds, or the toxins are inhaled.

A very small amount of the toxin can cause illness.

Risk Factors

Botulism risk is higher for:

  • Those who eat poorly preserved, cooked, or canned foods—especially home canned
  • Babies who eat honey
  • Those with a dirty or infected wound (rare)
  • IV drug users (rare)

Symptoms

Symptoms start in the face and eyes. Without care, muscles in the arms, legs, and torso will not move. This includes muscles that help with breathing.

Symptoms range from mild to serious.

In adults they may be:

  • Constipation
  • Vision or speech problems
  • Droopy eyelids
  • Tiredness
  • The feeling of spinning while standing still— vertigo
  • Sore throat
  • Dry mouth
  • Problems swallowing or breathing

In babies they may be:

  • Constipation
  • Not eating or sucking
  • Little energy
  • Floppy muscles
  • Weak cry

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Tests will be done to rule out other conditions and find the source of infection. They may include:

  • Blood and stool tests
  • Tests on stomach contents or food
  • Tests on your muscles and nerves
  • A swab of the wound

Treatment

Treatment will start right away, even if lab tests are not ready. This may involve:

  • Medicines such as:
    • Antitoxin—to stop further nerve damage
    • Antibiotics for any infected wounds
  • Supportive care in the hospital
  • Breathing support with a ventilator
  • Surgery to clean any wound, if needed

Intubation to Help Breathing
Intubation for respiration

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Prevention

The risk of botulism can be lowered by:

  • Learning how to can and cook food the right way
  • Not feeding honey to babies under 1 year old
  • Refrigerating oils that have garlic or herbs
  • Not eating food from a bulging can
  • Seeking care for wounds
  • Not using IV drugs
RESOURCES:

Centers for Disease Control and Prevention
https://www.cdc.gov

Food Safety—US Department of Health and Human Services
https://www.foodsafety.gov

CANADIAN RESOURCES:

Canadian Partnership for Consumer Food Safety Education
https://www.fightbac.org/

Public Health Agency of Canada
https://www.canada.ca

REFERENCES:

Botulism. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/botulism. Accessed February 1, 2021.

Botulism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/botulism. Accessed February 1, 2021.

Botulism. Food Safety—US Department of Health & Human Service website. Available at: https://www.foodsafety.gov/poisoning/causes/bacteriaviruses/botulism/index.html. Accessed February 1, 2021.

Friziero A, Sperti C, et al. Foodborne botulism presenting as small bowel obstruction: a case report. BMC Infectious Diseases, 1/12/2021; 21(1): 1-4.

Infant botulism. Kids Health—Nemours Foundation website. Available at: https://kidshealth.org/en/parents/botulism.html?ref=search. Accessed February 1, 2021.

Botulism. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/botulism. Accessed February 1, 2021.

Last reviewed September 2020 by David L. Horn, MD, FACP  Last Updated: 2/1/2021