RT Book, Section A1 Maslanka, Susan A1 K. Rao, Agam A2 Kasper, Dennis L. A2 Fauci, Anthony S. SR Print(0) ID 1141407849 T1 BOTULISM T2 Harrison's Infectious Diseases, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781259835971 LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1141407849 RD 2024/03/29 AB Botulism, recognized at least since the eighteenth century, is a neuroparalytic disease caused by botulinum toxin, one of the most toxic substances known. While initially thought to be caused only by the ingestion of botulinum toxin in contaminated food (food-borne botulism), three additional forms caused by in situ toxin production after germination of spores in either a wound or the intestine are now recognized worldwide: wound botulism, infant botulism, and adult intestinal colonization botulism. In addition to occurring in these recognized natural forms of the disease, botulism symptoms have been reported in patients receiving injections of botulinum toxin for cosmetic or therapeutic purposes (iatrogenic botulism). Moreover, botulism was reported after inhalation of botulinum toxin in a laboratory setting. All forms of botulism manifest as a relatively distinct clinical syndrome of symmetric cranial-nerve palsies followed by descending bilateral flaccid paralysis of voluntary muscles, which may progress to respiratory compromise and death. The mainstays of therapy are meticulous intensive care and treatment with antitoxin as soon as botulism is suspected and before other illnesses have been ruled out.