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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