Botulism: Clinical Description
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Risk Groups
- All persons. Injection drug users are at increased risk for wound botulism.
Incubation
- Foodborne botulism: typically 12-36 hours after toxin ingestion, but in rare cases as early as 6 hours or as late as 10 days after ingesting toxin.
- Wound botulism and infant botulism: it is difficult to estimate incubation period because exposure times cannot be ascertained.
- Inhalational botulism: same as foodborne botulism.
Symptoms
- Foodborne Botulism
- Symmetric cranial neuropathies such as diplopia, drooping eyelids, difficulty swallowing, dry mouth, altered voice, or difficulty speaking
- Symmetric descending flaccid paralysis in a proximal to distal pattern.
- Possibly but not necessarily:
- Abdominal pain
- Nausea
- Vomiting
- Diarrhea
- May progress to respiratory dysfunction from respiratory muscle paralysis.
- Infant Botulism
- Poor feeding
- Diminished suckling and crying ability
- Neck and peripheral weakness “floppy baby”
- Constipation
- Ventilatory failure
- Wound Botulism
- Neurological findings are indistinguishable from food-borne botulism without gastrointestinal symptoms
- Wounds may not be obviously or grossly infected but are usually deep and contain avascular areas.
For more information:
- Botulism: FAQ
- Facts about Botulism
- MMWR: Wound Botulism -- California, 1995
- MMWR: Foodborne Botulism -- Oklahoma, 1994
- MMWR: Wound Botulism Associated with Parenteral Cocaine Abuse -- New York City
- Botulism Facts for Health Care Providers
Page last reviewed October 06, 2006
Page last modified June 14, 2006