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Botulism

Tyler R. Reese, MD and Nicholas C. DeStefano, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A paralytic illness caused by a neurotoxin produced by the anaerobic bacterium Clostridium botulinum

  • Characterized by acute onset of cranial nerve dysfunction (diplopia, difficulty sw...

DIAGNOSIS

HISTORY

  • Adults

    • Acute onset of cranial nerve dysfunction

    • IV drug use, skin-popping, or cocaine use (wound botulism)

    • Retains normal mental state; no fever or sensory dysfunction

  • Infant botulism: Pr...

TREATMENT

MEDICATION

First Line

  • Antitoxin therapy with trivalent A-B-E antitoxin (4)[A]

    • Initiate botulinum antitoxin therapy based on symptoms and physical examination findings.

    • Early administration is im...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Outpatient follow-up with physical/occupational therapy, nutrition specialist, and psychiatry, as needed 

Patient Monitoring

  • Pulmonary function testing

  • Cardiorespira...

REFERENCES

1
Centers for Disease Control and Prevention. Botulism facts for healthcare providers. http://www.bt.cdc.gov/agent/Botulism/clinicians/epidemiology.asp. Accessed July 11, 2015.
2
Centers for D...

ADDITIONAL READING

Hill SE, Iqbal R, Cadiz CL, et al. Foodborne botulism treated with heptavalent botulism antitoxin. Ann Pharmacother.  2013;47(2):e12. 

SEE ALSO

Food Poisoning, Bacterial 

CODES

ICD10

  • A05.1 Botulism food poisoning

  • A48.52 Wound botulism

  • A48.51 Infant botulism

ICD9

  • 005.1 Botulism food poisoning

  • 040.42 Wound botulism

  • 040.41 Infant botulism

SNOMED

  • 398565003 Infection due to clostrid...

CLINICAL PEARLS

  • Botulism is diagnosed primarily on clinical suspicion.

  • Administer botulinum antitoxin as soon as disease is clinically suspected.

  • Contact state health authorities to report suspected cas...

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