Botulism is a gravely dangerous condition caused by a toxin produced by a bacterium called clostridium botulinum. Despite some usage of the toxin in pharmacotherapy (especially in plastic surgery), its effects are potentially fatal.


As mentioned above a bacterial toxin is the cause. Most frequent way of poisoning is by ingesting food infected by clostridium botulinum bacteria. Clostridium is an anaerobic organism, e.g. it lives in environments without oxygen presence like expired old sealed tins.


Those affected tins can be sometimes recognized by their bulging lids. It is connected to bacterial metabolism and overproduction of gases the force the wall of the can to bulge. If anyone eats the content of such suspicious tin, there is a great risk that he or she just swallowed a large amount of botulinum toxin. It is also quite insidious that clostridium bacteria and the toxin don’t significantly alter the taste of food.


In addition to this food form of botulism (e.g. ingested toxin), there is also a much rarer form known as infant botulism and wound-related botulism. Infant botulism occurs as a result of an overgrowth of clostridium bacteria in an immature intestinal mucosa that lacks protective intestinal flora. Clostridia may be present in honey products with insufficient hygienic standards during processing and therefore honey should not be given to infants under one year of age. Older children already have intestinal mucosa colonized by protective bacteria that do not allow proliferation of clostridium botulinum germs. Wound-related botulism occurs when clostridium bacteria infect a wound with damaged skin cover and start to release their toxin into our organism directly from the wound site.


Botulinum toxin is a potent neurotoxin. Its molecules block nerves that assure muscle movements. Weakness and muscle paralysis is the most typical symptom that is most dangerous when affecting the respiratory muscles. Double vision (by affection of ocular muscles) and swallowing disorders (by affection of esophageal musculature) also often occur.


Note: It is a condition quite opposite of tetanus. Tetanus is caused by a toxin produced by clostridium tetani that also affect muscles. Tetanus toxin leads to muscle spasms and not to weakness as botulism does. Final consequences are however the same - weak or cramped respiratory muscles don't function and the patient can die by suffocation.m Due to its effects botulinum toxin is used in small quantities in cosmetic industry and plastic surgery. Local application of the toxin causes paralysis of facial muscles and temporary disappearance of wrinkles.


When there is a suspicion because of above mentioned symptoms, the presence of toxins in the body must be proven in a special laboratory.


People should not eat food from suspiciously looking tins, infants should not be given honey from unknown sources and skin injuries should be correctly treated.


Hospitalization in a specialized center with permanent monitoring of life sings and possibility of external respiratory support is inevitable. Treatment is carried out by intravenous administration of special antibodies binding to toxin and neutralizing it.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources