Clostridium botulinum is a gram-positive, rod-shaped, spore-forming, obligate anaerobic bacteria. 

-It produces botulinum toxin, which is among the most potent toxins in nature

-The toxin acts by blocking release of acetylcholine at synapses and neuromuscular junctions, resulting in flaccid paralysis 

-Three important forms of botulism: infant botulism, foodborne botulism, and wound botulism 

Symptoms & Signs 

-Fully conscious patient; Cranial nerve palsies, descending symmetric motor paralysis  starting with ocular, laryngeal and respiratory muscles and spreading to the trunk and extremities, blurred vision, pupillary dilatation, nystagmus, inability to swallow

-Dry mouth, nausea, diarrhea, absence of fever 

Diagnosis 

-Diagnosis based on history and clinical examination 

-Toxin can be demonstrated in serum, gastric secretions, stools, remaining food by enzyme immunoassay or nucleic acid amplification 

-Isolation of C.botulinum from stool, wound specimens or food 

Treatment 

-Supportive care, mechanical ventilation, antitoxin, antimicrobial agents in wound botulism 

Q.What is the most frequent substance of infection in infant botulism? honey

Q.What is the best method to destroy botulinum toxin? Boiling 

Q.What is the most serious finding in botulism? Respiratory paralysis 

Q.What is the single most important determinant of clinical outcome in botulism? Mechanical ventilation