Podcast 748: Botulism

<p><strong>Contributor: Nick Hatch, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Botulism requires a prompt clinical diagnosis as lab results can take about 5 days to return</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Whale blubber, honey, home fermented foods, homemade wine (especially the wine made in prison), and improperly stored canned food can all contain the toxin</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">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</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Blocks release of acetylcholine at the neuromuscular junction preventing release of neurotransmitter and therefore the propagation of an electrical nerve potential</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Descending paralysis, often first including bulbar muscles, and anticholinergic symptoms can be present on exam</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">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</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Antitoxin is available to neutralize the botulism toxin present, but it cannot prevent the already established symptoms</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">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/</span></p> <p><em><span style="font-weight: 400;">Summarized by Joh