Materiały źródłowe

• #1 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Diagnosis of botulism depends on high clinical suspicion and a thorough neurologic examination. The timeliness of diagnosis is crucial to successful treatment because botulinum antitoxin, the only specific therapy for botulism, must be administered to patients as quickly as possible. […] Botulism typically produces a distinctive syndrome of cranial nerve palsies that can be followed by bilateral, symmetric, descending flaccid paralysis, affecting proximal before distal limb musculature, that might progress to respiratory failure and death. The extent and severity of paralysis is proportional to the dose of toxin.

• #2 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Neurologic symptoms are similar regardless of exposure route. […] Diagnosis of botulism depends on high clinical suspicion and a thorough neurologic examination. The timeliness of diagnosis is crucial to successful treatment because botulinum antitoxin, the only specific therapy for botulism, must be administered to patients as quickly as possible. […] Botulism typically produces a distinctive syndrome of cranial nerve palsies that can be followed by bilateral, symmetric, descending flaccid paralysis, affecting proximal before distal limb musculature, that might progress to respiratory failure and death.

• #3 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/botulism.aspx

  Botulism is a rare but serious disease caused by a toxin (poison) that attacks the nervous system and causes paralysis. Anyone can get botulism. […] People with botulism usually have weakness or paralysis that starts in the head and face and spreads down to the rest of the body. […] Without medical care, botulism can lead to death. If you or someone you know has symptoms of botulism, call 911 or go to the emergency room immediately. […] A person who becomes sick with botulism may have: Droopy eyelids, Double or blurry vision, Muscle weakness in the face, Trouble swallowing, Slurred speech or trouble speaking, Weakness in the arms and legs. […] A person with botulism might not have all of these symptoms at the same time. Botulism can also weaken the muscles that control breathing. Without medical care, botulism can lead to death.

• #4 Botulism – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/botulism/botulism+-+including+symptoms+treatment+and+prevention

  In foodborne botulism, toxin may be detected in the contaminated food item. […] Foodborne botulism: usually 12 to 36 hours, but sometimes several days. […] Wound botulism: up to 14 days. […] Inhalational botulism: probably between 12 hours and 3 days. […] An anti-toxin is available. […] In infant botulism, botulism immune globulin can be used (BabyBIG). […] In non-fatal cases, recovery may be prolonged.

• #5 Botulism – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/symptoms-causes/syc-20370262

  Symptoms of foodborne botulism typically begin 12 to 36 hours after the toxin gets into your body. But depending on how much toxin you consumed, the start of symptoms may range from a few hours to a few days. […] Symptoms of foodborne botulism include: Trouble swallowing or speaking, Dry mouth, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Nausea, vomiting and stomach cramps, Paralysis. […] Symptoms of wound botulism appear about 10 days after the toxin enters your body. Wound botulism symptoms include: Trouble swallowing or speaking, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Paralysis. […] Problems generally begin 18 to 36 hours after the toxin enters the baby’s body. Symptoms include: Constipation, which is often the first symptom, Floppy movements due to muscle weakness and trouble controlling the head, Weak cry, Irritability, Drooling, Drooping eyelids, Tiredness, Trouble sucking or feeding, Paralysis. […] In iatrogenic botulism when the toxin is injected for cosmetic or medical reasons there have been rare occurrences of serious side effects. These may include headache, facial paralysis, and muscle weakness.

• #6

  https://www.who.int/news-room/fact-sheets/detail/botulism

  Botulinum toxins are neurotoxic and therefore affect the nervous system. Foodborne botulism is characterized by descending, flaccid paralysis that can cause respiratory failure. Early symptoms include marked fatigue, weakness and vertigo, usually followed by blurred vision, dry mouth and difficulty in swallowing and speaking. Vomiting, diarrhoea, constipation and abdominal swelling may also occur. The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. There is no fever and no loss of consciousness. […] Symptoms usually appear within 12 to 36 hours (within a minimum and maximum range of 4 hours to 8 days) after exposure. Incidence of botulism is low, but the mortality rate is high if prompt diagnosis and appropriate, immediate treatment (early administration of antitoxin and intensive respiratory care) are not given. The disease can be fatal in 5 to 10% of cases. […] Following inhalation of the toxin, symptoms become visible between 13 days, with longer onset times for lower levels of intoxication. Symptoms proceed in a similar manner to ingestion of botulinum toxin and culminate in muscular paralysis and respiratory failure.

• #7 Symptoms of botulism – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/botulism/symptoms.html

  Symptoms of botulism can include: nausea, diarrhea, vomiting, dry mouth, constipation, drooping eyelids, difficulty swallowing, blurred or double vision, unreactive or fixed pupils, difficulty speaking, including slurred speech, partial facial paralysis or loss of facial expression, a change in sound of the voice, including hoarseness. […] Symptoms of botulism in infants include: nausea, drooling, vomiting, irritability, a weak cry, constipation, poor feeding, difficulty sucking, loss of head control, lethargy (tiredness), difficulty swallowing, progressive muscle weakness from the head downwards. […] Symptoms of food-borne botulism typically appear 12 to 72 hours after eating food or drinking beverages that contain the botulinum toxin. However, symptoms may appear as early as 2 hours or take up to 8 days. […] Symptoms of wound botulism take about 4 to 14 days to appear. […] Symptoms of infant botulism may take up to 30 days to appear.

• #8 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/botulism.aspx

  People with wound botulism may not have symptoms until several days after the wound is infected or injecting contaminated drugs. […] Botulism is a very serious disease that can be deadly if not treated. If caught early, botulism can be treated with botulinum antitoxin, which blocks the toxin from causing more harm in the body. But the antitoxin can’t undo any muscle paralysis that has already happened, so it can take weeks or even months for a person to get better.

• #9 Botulism – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/botulism/botulism+-+including+symptoms+treatment+and+prevention

  In foodborne botulism, toxin may be detected in the contaminated food item. […] Foodborne botulism: usually 12 to 36 hours, but sometimes several days. […] Wound botulism: up to 14 days. […] Inhalational botulism: probably between 12 hours and 3 days. […] An anti-toxin is available. […] In infant botulism, botulism immune globulin can be used (BabyBIG). […] In non-fatal cases, recovery may be prolonged.

• #10 Botulism – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/botulism.page

  There have been several cases in the U.S. of symptoms of botulism following botulinum toxin injections, often referred to as Botox. […] See your healthcare provider or go to the emergency room right away if you have any symptoms of botulism, including blurry or double vision, drooping eyelids, difficulty swallowing, difficulty breathing or muscle weakness. […] Symptoms can begin days or weeks following a botulinum toxin injection. […] With food-borne botulism, symptoms generally begin 18 to 36 hours after eating contaminated food. However, they can occur as soon as six hours or as many as 10 days after eating the contaminated food. For botulism caused by something other than food (such as botulinum toxin injections), symptoms may take days or weeks to develop. […] The symptoms all result from muscle paralysis caused by the botulinum toxin. If untreated, the disease may progress and symptoms may worsen to cause full paralysis of some muscles, including those used in breathing and those in the arms, legs and torso. […] Severe botulism can cause respiratory failure and paralysis, which may require a patient to be on a breathing machine (ventilator) for weeks to months and may require intensive care. Depending on the severity of the illness, the paralysis can slowly improve over the course of weeks to months.

• #11 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Signs and symptoms of botulism evolve over a period of hours to a few days. Initially, subjective symptoms of minor visual changes or (in patients with foodborne botulism) abdominal discomfort might occur, followed by progressive cranial palsies, which might then be followed by descending flaccid bilateral paralysis. […] Botulism causes progressive flaccid, descending paralysis that might result in respiratory compromise from upper airway collapse or respiratory muscle impairment. […] Patients with botulism should be monitored closely for neurologic, respiratory, and autonomic manifestations. Because of the potential for rapid clinical deterioration, frequent examination and other monitoring measures should be performed to allow prompt life-saving interventions. […] Botulism signs and symptoms occur in a typical order. Some patients initially have nausea and vomiting, then nearly all patients develop cranial nerve palsies; some develop respiratory failure and paralysis of the extremities. […] Paralysis can progress rapidly.

• #12 Symptoms of Botulism | Botulism | CDC

  https://www.cdc.gov/botulism/signs-symptoms/index.html

  Botulism is caused by a toxin that attacks the body’s nerves and causes muscle weakness. […] Botulism can weaken muscles used in breathing, which can lead to difficulty breathing and even death. […] Botulism is an emergency. People with symptoms should see a doctor or go to the emergency room immediately. […] Difficulty swallowing […] Muscle weakness […] Double vision […] Drooping eyelids […] Blurry vision […] Slurred speech […] Difficulty breathing […] Difficulty moving the eyes. […] Signs and symptoms in foodborne botulism also might include: Vomiting […] Nausea […] Stomach pain […] Diarrhea. […] Signs and symptoms in an infant might include: Constipation […] Poor feeding […] Drooping eyelids […] Pupils that are slow to react to light […] Face showing less expression than usual

• #13

  https://www.who.int/news-room/fact-sheets/detail/botulism

  Botulinum toxins are neurotoxic and therefore affect the nervous system. Foodborne botulism is characterized by descending, flaccid paralysis that can cause respiratory failure. Early symptoms include marked fatigue, weakness and vertigo, usually followed by blurred vision, dry mouth and difficulty in swallowing and speaking. Vomiting, diarrhoea, constipation and abdominal swelling may also occur. The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. There is no fever and no loss of consciousness. […] Symptoms usually appear within 12 to 36 hours (within a minimum and maximum range of 4 hours to 8 days) after exposure. Incidence of botulism is low, but the mortality rate is high if prompt diagnosis and appropriate, immediate treatment (early administration of antitoxin and intensive respiratory care) are not given. The disease can be fatal in 5 to 10% of cases. […] Following inhalation of the toxin, symptoms become visible between 13 days, with longer onset times for lower levels of intoxication. Symptoms proceed in a similar manner to ingestion of botulinum toxin and culminate in muscular paralysis and respiratory failure.

• #14 Clostridium botulinum & Botulism | Food Safety and Inspection Service

  http://www.fsis.usda.gov/food-safety/foodborne-illness-and-disease/illnesses-and-pathogens/botulism

  Once in the body, the toxin binds to nerve endings that join muscles. This prevents the nerves from signaling the muscles to contract. The first symptoms of botulism are nausea, vomiting, weakness, and vertigo (dizziness). These are followed by neurological symptoms: visual impairments (blurred or double vision), loss of normal throat and mouth functions (difficulty speaking and swallowing; dry mouth, throat, and tongue; and sore throat), general fatigue, lack of muscle coordination, and difficulty in breathing. Gastrointestinal symptoms may include abdominal pain, diarrhea, or constipation. Death is usually caused by respiratory failure and airway obstructions. […] If botulism is caught in the early stages, the injection of an antitoxin can lessen the severity of the disease by neutralizing any toxin that has not yet bound to nerve endings. However, due to the risk of serious side effects, the antitoxin cannot always be used.

• #15 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Diagnosis of botulism depends on high clinical suspicion and a thorough neurologic examination. The timeliness of diagnosis is crucial to successful treatment because botulinum antitoxin, the only specific therapy for botulism, must be administered to patients as quickly as possible. […] Botulism typically produces a distinctive syndrome of cranial nerve palsies that can be followed by bilateral, symmetric, descending flaccid paralysis, affecting proximal before distal limb musculature, that might progress to respiratory failure and death. The extent and severity of paralysis is proportional to the dose of toxin.

• #16 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  The extent and severity of paralysis is proportional to the dose of toxin. […] Signs and symptoms of botulism evolve over a period of hours to a few days. Initially, subjective symptoms of minor visual changes or (in patients with foodborne botulism) abdominal discomfort might occur, followed by progressive cranial palsies, which might then be followed by descending flaccid bilateral paralysis. […] Botulism is typically described as producing symmetric neurologic deficits, and the pathophysiological mechanism of the disease is consistent with this description. […] Respiratory failure without preceding neurologic deficits has rarely been reported as the presenting symptom. […] Botulism causes progressive flaccid, descending paralysis that might result in respiratory compromise from upper airway collapse or respiratory muscle impairment.

• #17 Botulism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/213311-overview

  Botulism generally progresses as follows: […] Preceding or following the onset of paralysis are nonspecific findings such as nausea, vomiting, abdominal pain, malaise, dizziness, dry mouth, dry throat, and, occasionally, sore throat. […] Cranial nerve paralysis manifests as blurred vision, diplopia, ptosis, extraocular muscle weakness or paresis, fixed/dilated pupils, dysarthria, dysphagia, and/or suppressed gag reflex. […] Additional neurologic manifestations include symmetrical descending paralysis or weakness of motor and autonomic nerves. […] Respiratory muscle weakness may be subtle or progressive, advancing rapidly to respiratory failure. […] The autonomic nervous system is also involved in botulism (typically in cases caused by toxin type B), with manifestations that include the following:

• #18 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Botulism is a rare but life-threatening neuroparalytic syndrome caused by the botulinum neurotoxin, most often produced by the bacterium Clostridium botulinum. The condition begins with symmetrical cranial nerve paralysis and progresses to descending, symmetrical weakness affecting the trunk and extremities, potentially leading to complete flaccid paralysis. Severe respiratory compromise is common, requiring mechanical ventilation, and mortality can occur if treatment is delayed. […] Botulism classically begins with cranial nerve palsies (bulbar symptoms) that progress to a symmetrical descending weakness of the trunk, extremities, and smooth muscles, with eventual flaccid paralysis. However, these symptoms usually begin following early symptoms that include marked lassitude, diplopia, ptosis, ophthalmoparesis, dysphagia, dysphonia, and dysarthria, reflecting the high susceptibility of cranial nerve efferent presynaptic terminals to BoNT activity.

• #19 Botulism

  https://www.nhs.uk/conditions/botulism/

  Most people will make a full recovery with treatment, but the paralysis can spread to the muscles that control breathing if it is not treated quickly. This is fatal in around 5 to 10% of cases. […] The time it takes to develop symptoms can vary from a few hours to several days after exposure to the Clostridium botulinum bacteria or their toxins. […] Without treatment, botulism eventually causes paralysis that spreads down the body from the head to the legs. […] Symptoms can include: drooping eyelids, blurred or double vision, facial muscle weakness, difficulty swallowing (dysphagia), slurred speech, breathing difficulties. […] Affected babies may also have a weak cry, find it difficult to feed, and have a floppy head, neck and limbs. […] Treatment will not immediately reverse any paralysis that’s already been caused by the toxin, but will stop it getting any worse. […] In most people, paralysis that occurred before treatment will gradually improve over the following weeks or months.

• #20 Botulism – Wikipedia

  https://en.wikipedia.org/wiki/Botulism

  Botulism is a rare and potentially fatal illness caused by botulinum toxin, which is produced by the bacterium Clostridium botulinum. The disease begins with weakness, blurred vision, feeling tired, and trouble speaking. This may then be followed by weakness of the arms, chest muscles, and legs. Vomiting, swelling of the abdomen, and diarrhea may also occur. The disease does not usually affect consciousness or cause a fever. […] The muscle weakness of botulism characteristically starts in the muscles supplied by the cranial nerves—a group of twelve nerves that control eye movements, the facial muscles and the muscles controlling chewing and swallowing. Double vision, drooping of both eyelids, loss of facial expression and swallowing problems may therefore occur. […] The weakness then spreads to the arms (starting in the shoulders and proceeding to the forearms) and legs (again from the thighs down to the feet).

• #21 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  The extent and severity of paralysis is proportional to the dose of toxin. […] Signs and symptoms of botulism evolve over a period of hours to a few days. Initially, subjective symptoms of minor visual changes or (in patients with foodborne botulism) abdominal discomfort might occur, followed by progressive cranial palsies, which might then be followed by descending flaccid bilateral paralysis. […] Botulism is typically described as producing symmetric neurologic deficits, and the pathophysiological mechanism of the disease is consistent with this description. […] Respiratory failure without preceding neurologic deficits has rarely been reported as the presenting symptom. […] Botulism causes progressive flaccid, descending paralysis that might result in respiratory compromise from upper airway collapse or respiratory muscle impairment.

• #22 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Diagnosis of botulism depends on high clinical suspicion and a thorough neurologic examination. The timeliness of diagnosis is crucial to successful treatment because botulinum antitoxin, the only specific therapy for botulism, must be administered to patients as quickly as possible. […] Botulism typically produces a distinctive syndrome of cranial nerve palsies that can be followed by bilateral, symmetric, descending flaccid paralysis, affecting proximal before distal limb musculature, that might progress to respiratory failure and death. The extent and severity of paralysis is proportional to the dose of toxin.

• #23 Botulism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/213311-overview

  Paralytic ileus advancing to severe constipation. […] Gastric dilatation. […] Bladder distention advancing to urinary retention. […] Orthostatic hypotension. […] Reduced salivation. […] Reduced lacrimation. […] Other neurologic findings include the following: […] Changes in deep tendon reflexes, which may be either intact or diminished. […] Incoordination due to muscle weakness. […] Absence of pathologic reflexes and normal findings on sensory and gait examinations. […] Normal results on mental status examination. […] The recovery period from botulism flaccid paralysis takes weeks to months. […] Death that occurs early in the course of disease is usually secondary to acute respiratory failure, whereas death later in the course of illness is typically secondary to complications associated with prolonged intensive care (ie, venous thromboembolism or hospital-acquired infection). […] Some patients demonstrate residual weakness or autonomic dysfunction for 1 year after the onset of the illness. […] However, most patients achieve full neurologic recovery. […] Permanent deficits may occur in those who sustain significant hypoxic insults.

• #24 Botulism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1203301-clinical

  Paralytic ileus advancing to severe constipation. […] Gastric dilatation. […] Bladder distention advancing to urinary retention. […] Orthostatic hypotension. […] Reduced salivation. […] Reduced lacrimation. […] Other neurologic findings include the following: […] Changes in deep tendon reflexes, which may be either intact or diminished. […] Incoordination due to muscle weakness. […] Absence of pathologic reflexes and normal findings on sensory and gait examinations. […] Normal results on mental status examination. […] Ocular manifestations may be the manifesting features of botulism. However, their absence does not exclude this disease, since the 8 different toxins appear to involve the ocular system to various degrees. […] The recovery period from botulism flaccid paralysis takes weeks to months.

• #25 Symptoms of Botulism | Botulism | CDC

  https://www.cdc.gov/botulism/signs-symptoms/index.html

  Weak cry that sounds different than usual. […] Botulism can weaken the muscles involved in breathing, which can lead to difficulty breathing and even death. […] Botulism is a medical emergency. If you or your child has signs and symptoms of botulism, immediately see your doctor or go to the emergency room. […] Botulism is a rare but serious illness caused by a toxin that attacks the body’s nerves and causes difficulty breathing, muscle paralysis, and even death.

• #26 Botulism – Wikipedia

  https://en.wikipedia.org/wiki/Botulism

  Severe botulism leads to reduced movement of the muscles of respiration, and hence problems with gas exchange. This may be experienced as dyspnea (difficulty breathing), but when severe can lead to respiratory failure, due to the buildup of unexhaled carbon dioxide and its resultant depressant effect on the brain. […] The paralysis caused by botulism can persist for two to eight weeks, during which supportive care and ventilation may be necessary to keep the patient alive. Botulism can be fatal in five to ten percent of people who are affected. However, if left untreated, botulism is fatal in 40 to 50 percent of cases. […] Typical symptoms of infant botulism include constipation, lethargy, weakness, difficulty feeding, and an altered cry, often progressing to a complete descending flaccid paralysis. Although constipation is usually the first symptom of infant botulism, it is commonly overlooked.

• #27 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Signs and symptoms of botulism evolve over a period of hours to a few days. Initially, subjective symptoms of minor visual changes or (in patients with foodborne botulism) abdominal discomfort might occur, followed by progressive cranial palsies, which might then be followed by descending flaccid bilateral paralysis. […] Botulism causes progressive flaccid, descending paralysis that might result in respiratory compromise from upper airway collapse or respiratory muscle impairment. […] Patients with botulism should be monitored closely for neurologic, respiratory, and autonomic manifestations. Because of the potential for rapid clinical deterioration, frequent examination and other monitoring measures should be performed to allow prompt life-saving interventions. […] Botulism signs and symptoms occur in a typical order. Some patients initially have nausea and vomiting, then nearly all patients develop cranial nerve palsies; some develop respiratory failure and paralysis of the extremities. […] Paralysis can progress rapidly.

• #28 Botulism – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/symptoms-causes/syc-20370262

  Symptoms of foodborne botulism typically begin 12 to 36 hours after the toxin gets into your body. But depending on how much toxin you consumed, the start of symptoms may range from a few hours to a few days. […] Symptoms of foodborne botulism include: Trouble swallowing or speaking, Dry mouth, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Nausea, vomiting and stomach cramps, Paralysis. […] Symptoms of wound botulism appear about 10 days after the toxin enters your body. Wound botulism symptoms include: Trouble swallowing or speaking, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Paralysis. […] Problems generally begin 18 to 36 hours after the toxin enters the baby’s body. Symptoms include: Constipation, which is often the first symptom, Floppy movements due to muscle weakness and trouble controlling the head, Weak cry, Irritability, Drooling, Drooping eyelids, Tiredness, Trouble sucking or feeding, Paralysis. […] In iatrogenic botulism when the toxin is injected for cosmetic or medical reasons there have been rare occurrences of serious side effects. These may include headache, facial paralysis, and muscle weakness.

• #29 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/botulism.aspx

  Babies younger than 15 months old can get infant botulism and may appear tired, show little facial expression, have a weak cry or poor head control, and appear floppy because they can’t control their muscles. […] If you or someone you know has symptoms of botulism, call 911 or go to the emergency room immediately. […] Botulism symptoms include trouble swallowing, droopy eyelids, blurry vision, slurred speech, weak muscles, and trouble breathing. […] If not treated quickly, paralysis from botulism starts in the head and face and usually moves down the body, causing breathing problems, full paralysis, and even death. About 1 in 20 people who get botulism die from respiratory failure or the result of long-term paralysis. […] Symptoms of foodborne botulism usually begin about 18 to 36 hours after eating or drinking something that is contaminated with the botulinum toxin, but symptoms can occur as early as 6 hours or as late as 10 days.

• #30 Botulism – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/symptoms-causes/syc-20370262

  Symptoms of foodborne botulism typically begin 12 to 36 hours after the toxin gets into your body. But depending on how much toxin you consumed, the start of symptoms may range from a few hours to a few days. […] Symptoms of foodborne botulism include: Trouble swallowing or speaking, Dry mouth, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Nausea, vomiting and stomach cramps, Paralysis. […] Symptoms of wound botulism appear about 10 days after the toxin enters your body. Wound botulism symptoms include: Trouble swallowing or speaking, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Paralysis. […] Problems generally begin 18 to 36 hours after the toxin enters the baby’s body. Symptoms include: Constipation, which is often the first symptom, Floppy movements due to muscle weakness and trouble controlling the head, Weak cry, Irritability, Drooling, Drooping eyelids, Tiredness, Trouble sucking or feeding, Paralysis. […] In iatrogenic botulism when the toxin is injected for cosmetic or medical reasons there have been rare occurrences of serious side effects. These may include headache, facial paralysis, and muscle weakness.

• #31 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  Botulism symptoms include muscle weakness and paralysis. […] Symptoms may include drooping eyelids and other signs affecting the muscles of your face, eyes and throat. It can eventually affect muscles related to breathing. […] Botulism symptoms include drooping eyelids, double or blurred vision, dry mouth, difficulty swallowing and breathing. Botulism symptoms affect your ability to see, talk, swallow, move and/or breathe. […] Symptoms of infant botulism can range from mild to severe. They may develop anywhere from three to 30 days after exposure to Clostridium botulinum spores. Symptoms of infant botulism can include: Drooping eyelids (ptosis), Loss of facial expression, Drooling, Weakened cry, Slow or poor feeding, Reduced gag reflex, Constipation, Weakness or floppiness, Difficulty breathing.

• #32 Symptoms of Botulism | Botulism | CDC

  https://www.cdc.gov/botulism/signs-symptoms/index.html

  Botulism is caused by a toxin that attacks the body’s nerves and causes muscle weakness. […] Botulism can weaken muscles used in breathing, which can lead to difficulty breathing and even death. […] Botulism is an emergency. People with symptoms should see a doctor or go to the emergency room immediately. […] Difficulty swallowing […] Muscle weakness […] Double vision […] Drooping eyelids […] Blurry vision […] Slurred speech […] Difficulty breathing […] Difficulty moving the eyes. […] Signs and symptoms in foodborne botulism also might include: Vomiting […] Nausea […] Stomach pain […] Diarrhea. […] Signs and symptoms in an infant might include: Constipation […] Poor feeding […] Drooping eyelids […] Pupils that are slow to react to light […] Face showing less expression than usual

• #33 Botulism – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/symptoms-causes/syc-20370262

  Symptoms of foodborne botulism typically begin 12 to 36 hours after the toxin gets into your body. But depending on how much toxin you consumed, the start of symptoms may range from a few hours to a few days. […] Symptoms of foodborne botulism include: Trouble swallowing or speaking, Dry mouth, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Nausea, vomiting and stomach cramps, Paralysis. […] Symptoms of wound botulism appear about 10 days after the toxin enters your body. Wound botulism symptoms include: Trouble swallowing or speaking, Facial weakness on both sides of the face, Blurred or double vision, Drooping eyelids, Trouble breathing, Paralysis. […] Problems generally begin 18 to 36 hours after the toxin enters the baby’s body. Symptoms include: Constipation, which is often the first symptom, Floppy movements due to muscle weakness and trouble controlling the head, Weak cry, Irritability, Drooling, Drooping eyelids, Tiredness, Trouble sucking or feeding, Paralysis. […] In iatrogenic botulism when the toxin is injected for cosmetic or medical reasons there have been rare occurrences of serious side effects. These may include headache, facial paralysis, and muscle weakness.

• #34 Wound Botulism Cases Associated with Injection Drug Use | Texas DSHS

  https://www.dshs.texas.gov/news-alerts/wound-botulism-cases-associated-injection-drug-use

  Wound botulism is a rare and potentially fatal paralytic illness that is caused when a wound is contaminated by Clostridium botulinum spores that germinate and produce neurotoxins inside the wound. Affected patients typically present with a sudden paralysis or weakness in the muscles of both sides of the face that can cause blurred or double vision, drooping eyelids, slurred speech, difficulty swallowing, or an impaired gag reflex. The initial symptoms are often followed by paralysis that progresses down the body to the trunk, arms, and legs. […] The classic symptoms of botulism include: Blurred or double vision, Drooping eyelids, Slurred speech, Difficulty swallowing or speaking, Dry mouth, Muscle weakness, Muscle paralysis, which may start with the face and progress down the body to the trunk, arms, and legs. […] Initial presentations can be mild but quickly progress to severe illness. […] If untreated, the illness may progress to paralysis of the arms, legs, and respiratory muscles and cause death.

• #35 Botulism

  https://www.nhs.uk/conditions/botulism/

  Most people will make a full recovery with treatment, but the paralysis can spread to the muscles that control breathing if it is not treated quickly. This is fatal in around 5 to 10% of cases. […] The time it takes to develop symptoms can vary from a few hours to several days after exposure to the Clostridium botulinum bacteria or their toxins. […] Without treatment, botulism eventually causes paralysis that spreads down the body from the head to the legs. […] Symptoms can include: drooping eyelids, blurred or double vision, facial muscle weakness, difficulty swallowing (dysphagia), slurred speech, breathing difficulties. […] Affected babies may also have a weak cry, find it difficult to feed, and have a floppy head, neck and limbs. […] Treatment will not immediately reverse any paralysis that’s already been caused by the toxin, but will stop it getting any worse. […] In most people, paralysis that occurred before treatment will gradually improve over the following weeks or months.

• #36 Botulism – Wikipedia

  https://en.wikipedia.org/wiki/Botulism

  Severe botulism leads to reduced movement of the muscles of respiration, and hence problems with gas exchange. This may be experienced as dyspnea (difficulty breathing), but when severe can lead to respiratory failure, due to the buildup of unexhaled carbon dioxide and its resultant depressant effect on the brain. […] The paralysis caused by botulism can persist for two to eight weeks, during which supportive care and ventilation may be necessary to keep the patient alive. Botulism can be fatal in five to ten percent of people who are affected. However, if left untreated, botulism is fatal in 40 to 50 percent of cases. […] Typical symptoms of infant botulism include constipation, lethargy, weakness, difficulty feeding, and an altered cry, often progressing to a complete descending flaccid paralysis. Although constipation is usually the first symptom of infant botulism, it is commonly overlooked.

• #37

  https://www.who.int/news-room/fact-sheets/detail/botulism

  Botulinum toxins are neurotoxic and therefore affect the nervous system. Foodborne botulism is characterized by descending, flaccid paralysis that can cause respiratory failure. Early symptoms include marked fatigue, weakness and vertigo, usually followed by blurred vision, dry mouth and difficulty in swallowing and speaking. Vomiting, diarrhoea, constipation and abdominal swelling may also occur. The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. There is no fever and no loss of consciousness. […] Symptoms usually appear within 12 to 36 hours (within a minimum and maximum range of 4 hours to 8 days) after exposure. Incidence of botulism is low, but the mortality rate is high if prompt diagnosis and appropriate, immediate treatment (early administration of antitoxin and intensive respiratory care) are not given. The disease can be fatal in 5 to 10% of cases. […] Following inhalation of the toxin, symptoms become visible between 13 days, with longer onset times for lower levels of intoxication. Symptoms proceed in a similar manner to ingestion of botulinum toxin and culminate in muscular paralysis and respiratory failure.

• #38 Botulism

  https://www.nhs.uk/conditions/botulism/

  Most people will make a full recovery with treatment, but the paralysis can spread to the muscles that control breathing if it is not treated quickly. This is fatal in around 5 to 10% of cases. […] The time it takes to develop symptoms can vary from a few hours to several days after exposure to the Clostridium botulinum bacteria or their toxins. […] Without treatment, botulism eventually causes paralysis that spreads down the body from the head to the legs. […] Symptoms can include: drooping eyelids, blurred or double vision, facial muscle weakness, difficulty swallowing (dysphagia), slurred speech, breathing difficulties. […] Affected babies may also have a weak cry, find it difficult to feed, and have a floppy head, neck and limbs. […] Treatment will not immediately reverse any paralysis that’s already been caused by the toxin, but will stop it getting any worse. […] In most people, paralysis that occurred before treatment will gradually improve over the following weeks or months.

• #39 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  Symptoms of botulism in older children and adults usually begin in the muscles of your face, eyes and throat. Without treatment, symptoms can spread to other parts of your body. Signs can appear from a few hours to several days after ingesting botulism spores. Symptoms include: Drooping eyelids (ptosis), Double or blurred vision, Dry mouth (xerostomia), Slurred speech, Difficulty swallowing (dysphagia), Difficulty breathing, Weakness or paralysis of your arms or legs, Nausea and vomiting. […] Botulism can paralyze the muscles that help you swallow and breathe. While antitoxins can help in many cases, some people do die of breathing problems and infections. […] Depending on the severity of your case, recovery from botulism can take weeks, months or even years. Most people who receive prompt treatment recover completely in fewer than two weeks.

• #40 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Just as infant botulism has a characteristic presentation, so too the course of the disease has some generally predictable features. Hospitalized patients usually have acute to subacute onset of symptoms over several days, with progression of weakness (usually manifesting as feeding or breathing difficulties) that finally necessitates hospital admission. […] In patients not treated with BabyBIG whose weakness continues to advance, the low point is generally reached within 1-2 weeks after admission. Patients may remain at this stage for as long as 2-3 weeks before showing improvement. Once improvement begins, it continues, albeit slowly, over the subsequent weeks. Average hospital stay for non-BabyBIG-treated patients is approximately 5.7 weeks. In contrast, patients treated with BabyBIG have an average hospital stay of approximately 2.3 weeks, and their recovery of strength, tone and movement occurs more rapidly.

• #41 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Infant botulism does not usually have a relapsing course, and regression in a patient who has been gradually improving should immediately alert the physician to suspect additional complications or inadequate nutritional or respiratory support. The patient may be discharged when the patient has shown steady recovery and is able to feed p.o. (or when the parents are comfortable with gavage feeding). Although head-lag and constipation may still be pronounced at this point, the parents may be reassured that these are expected and that over time, full recovery will occur. […] As discussed earlier, the pattern of recovery in infant botulism is that of gradual improvement in muscle function. This gradual recovery may be difficult to discern during daily observation. However, a patient who has made gains and then falters should prompt the physician to reverse premature weaning of respiratory and nutritional support and to search for possible complications.

• #42 Botulism Outcomes and Long-Term and Permanent Injury | Marler Clark

  https://marlerclark.com/foodborne-illnesses/botulism/botulism-outcomes-and-long-term-and-permanent-injury

  In the past 50 years, mortality from botulism has fallen dramatically (from about 50% to 8%) because of advances in supportive care, which is the mainstay of treatment. The respiratory failure and paralysis that occur with severe botulism may require a patient to be on a ventilator for weeks, plus intensive medical and nursing care. After several weeks, the paralysis slowly improves. Recovery from botulism takes many weeks. […] Although a minority of botulism patients eventually recover their pre-infection health, the majority do not. For those who fully recover, the greatest improvement in muscle strength occurs in the first three months after the acute phase of illness. The outside limit for such improvement appears, however, to be one year. Consequently, physical limitations that still exist beyond the one-year mark are more probably than not permanent. Recovery from acute botulism symptoms may also be followed by persistent psychological dysfunction that may require intervention.

• #43 Botulism Outcomes and Long-Term and Permanent Injury | Marler Clark

  https://marlerclark.com/foodborne-illnesses/botulism/botulism-outcomes-and-long-term-and-permanent-injury

  Even several years after acute illness, patients who had botulism were more likely than control subjects to experience fatigue, generalized weakness, dizziness, dry mouth, difficulty lifting things, and difficulty breathing caused by moderate exertion. In addition, patients reported worse overall psycho-social status than did control subjects, with patients being significantly less likely to report feeling happy, calm and peaceful, or full of pep.

• #44 Botulism Outcomes and Long-Term and Permanent Injury | Marler Clark

  https://marlerclark.com/foodborne-illnesses/botulism/botulism-outcomes-and-long-term-and-permanent-injury

  In the past 50 years, mortality from botulism has fallen dramatically (from about 50% to 8%) because of advances in supportive care, which is the mainstay of treatment. The respiratory failure and paralysis that occur with severe botulism may require a patient to be on a ventilator for weeks, plus intensive medical and nursing care. After several weeks, the paralysis slowly improves. Recovery from botulism takes many weeks. […] Although a minority of botulism patients eventually recover their pre-infection health, the majority do not. For those who fully recover, the greatest improvement in muscle strength occurs in the first three months after the acute phase of illness. The outside limit for such improvement appears, however, to be one year. Consequently, physical limitations that still exist beyond the one-year mark are more probably than not permanent. Recovery from acute botulism symptoms may also be followed by persistent psychological dysfunction that may require intervention.

• #45 Botulism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1203301-clinical

  Paralytic ileus advancing to severe constipation. […] Gastric dilatation. […] Bladder distention advancing to urinary retention. […] Orthostatic hypotension. […] Reduced salivation. […] Reduced lacrimation. […] Other neurologic findings include the following: […] Changes in deep tendon reflexes, which may be either intact or diminished. […] Incoordination due to muscle weakness. […] Absence of pathologic reflexes and normal findings on sensory and gait examinations. […] Normal results on mental status examination. […] Ocular manifestations may be the manifesting features of botulism. However, their absence does not exclude this disease, since the 8 different toxins appear to involve the ocular system to various degrees. […] The recovery period from botulism flaccid paralysis takes weeks to months.

• #46 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Signs and symptoms of botulism evolve over a period of hours to a few days. Initially, subjective symptoms of minor visual changes or (in patients with foodborne botulism) abdominal discomfort might occur, followed by progressive cranial palsies, which might then be followed by descending flaccid bilateral paralysis. […] Botulism causes progressive flaccid, descending paralysis that might result in respiratory compromise from upper airway collapse or respiratory muscle impairment. […] Patients with botulism should be monitored closely for neurologic, respiratory, and autonomic manifestations. Because of the potential for rapid clinical deterioration, frequent examination and other monitoring measures should be performed to allow prompt life-saving interventions. […] Botulism signs and symptoms occur in a typical order. Some patients initially have nausea and vomiting, then nearly all patients develop cranial nerve palsies; some develop respiratory failure and paralysis of the extremities. […] Paralysis can progress rapidly.

• #47 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  Patients with botulism should be monitored closely for neurologic, respiratory, and autonomic manifestations. […] Botulinum antitoxin, the only specific therapy for botulism, should be administered as quickly as possible. […] The only specific therapy for botulism is botulinum antitoxin. When administered early in the course of illness, botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients. […] Almost all patients with botulism can survive, even without antitoxin, if they receive supportive care, including mechanical ventilation, when required. […] The standard adult dose of BAT contains sufficient amounts of antitoxin types A, B, C, E, and F to neutralize approximately 100-fold the measured serum toxin level for virtually all patients with botulism type A, B, or E.

• #48 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  To diagnose botulism, your health care provider checks you for muscle weakness or paralysis. Your provider looks for symptoms such as drooping eyelids and a weak voice. […] In cases of possible infant botulism, the provider may ask if your child has eaten honey recently. The provider may also ask if your infant has constipation or has been less active than usual. […] Symptoms related to injections of botulinum toxin for cosmetic or medical reasons usually improve as the toxin is absorbed by the body. […] If you’re diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that’s moving through your bloodstream and keeps it from harming your nerves. […] The antitoxin can’t reverse damage that’s already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy. […] If you’re having trouble breathing, you probably need a mechanical ventilator for up to several weeks while your body fights the toxin’s effects. […] As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by botulism.

• #49 Botulism: Causes, Symptoms & Diagnosis

  https://www.healthline.com/health/botulism

  Symptoms of botulism can appear from six hours to 10 days after the initial infection. On average, symptoms of infant and foodborne botulism appear between 12 and 36 hours after eating contaminated food. […] Early signs of infant botulism include: constipation, difficulty feeding, tiredness, irritability, drooling, drooping eyelids, weak cry, loss of head control and floppy movements due to muscle weakness, paralysis. […] Signs of foodborne or wound botulism include: difficulty swallowing or speaking, facial weakness on both sides of the face, blurred vision, drooping eyelids, trouble breathing, nausea, vomiting, and abdominal cramps (only in foodborne botulism), paralysis. […] For foodborne and wound botulism, a doctor administers an antitoxin as soon as possible after diagnosis. In infants, a treatment known as botulism immune globulin blocks the actions of neurotoxins circulating in the blood. […] Severe cases of botulism may require the use of a ventilator to help support breathing. Recovery may take weeks or months. Long-term therapy and rehabilitation may also be necessary in severe cases.

• #50 Infant Botulism (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/botulism.html

  Infant botulism is an illness that can happen when a baby ingests (takes in) toxins from a type of bacteria. Babies with infant botulism can have muscle weakness, a weak cry, and trouble breathing. They need to be treated in a hospital. With early diagnosis and proper medical care, a baby should fully recover from the illness. […] Babies with infant botulism might have: constipation (often the first sign that parents notice), weak facial muscles that makes their face look „flat”, a weak cry, weak muscles in the arms, legs, and neck, leading to floppiness, breathing problems, trouble swallowing with a lot of drooling. […] Doctors treat infant botulism with an antitoxin called botulism immune globulin intravenous (BIGIV). They give this to babies as soon as possible if they suspect botulism. Babies with botulism who get BIGIV early recover sooner and spend less time in the hospital than babies who don’t.

• #51 Symptoms of Botulism | Botulism | CDC

  https://www.cdc.gov/botulism/signs-symptoms/index.html

  Botulism is caused by a toxin that attacks the body’s nerves and causes muscle weakness. […] Botulism can weaken muscles used in breathing, which can lead to difficulty breathing and even death. […] Botulism is an emergency. People with symptoms should see a doctor or go to the emergency room immediately. […] Difficulty swallowing […] Muscle weakness […] Double vision […] Drooping eyelids […] Blurry vision […] Slurred speech […] Difficulty breathing […] Difficulty moving the eyes. […] Signs and symptoms in foodborne botulism also might include: Vomiting […] Nausea […] Stomach pain […] Diarrhea. […] Signs and symptoms in an infant might include: Constipation […] Poor feeding […] Drooping eyelids […] Pupils that are slow to react to light […] Face showing less expression than usual

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