Emergency Medical Minute18 Jan 2022

Podcast 748: Botulism

Contributor: Nick Hatch, MD

Educational Pearls:

Botulism requires a prompt clinical diagnosis as lab results can take about 5 days to return
Whale blubber, honey, home fermented foods, homemade wine (especially the wine made in prison), and improperly stored canned food can all contain the toxin
The botulinum toxin is create by a Clostridium botulinum that is prevalent on our food and in the soil, but the toxin is readily degraded with heat and light
Blocks release of acetylcholine at the neuromuscular junction preventing release of neurotransmitter and therefore the propagation of an electrical nerve potential
Descending paralysis, often first including bulbar muscles, and anticholinergic symptoms can be present on exam
Infantile botulism, classically seen as floppy baby syndrome, occurs up to a week after ingestion, because the infant GI tract is not acidic enough to deactivate the toxin
Antitoxin is available to neutralize the botulism toxin present, but it cannot prevent the already established symptoms

References

Jeffery IA, Karim S. Botulism. [Updated 2021 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459273/

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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