Botulism is caused by bacteria that makes toxins. It can cause a type of food poisoning. Rarely, the bacteria enter the blood through wounds, or the toxins are inhaled.

A very small amount of the toxin can cause illness.

Risk Factors

Botulism risk is higher for:

Those who eat poorly preserved, cooked, or canned foods—especially home canned
Babies who eat honey
Those with a dirty or infected wound (rare)
IV drug users (rare)

Symptoms

Symptoms start in the face and eyes. Without care, muscles in the arms, legs, and torso will not move. This includes muscles that help with breathing.

Symptoms range from mild to serious.

In adults they may be:

Constipation
Vision or speech problems
Droopy eyelids
Tiredness
The feeling of spinning while standing still— vertigo
Sore throat
Dry mouth
Problems swallowing or breathing

In babies they may be:

Constipation
Not eating or sucking
Little energy
Floppy muscles
Weak cry

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Tests will be done to rule out other conditions and find the source of infection. They may include:

Blood and stool tests
Tests on stomach contents or food
Tests on your muscles and nerves
A swab of the wound

Treatment

Treatment will start right away, even if lab tests are not ready. This may involve:

Medicines such as:
- Antitoxin—to stop further nerve damage
- Antibiotics for any infected wounds
Supportive care in the hospital
Breathing support with a ventilator
Surgery to clean any wound, if needed

Intubation to Help Breathing

Prevention

The risk of botulism can be lowered by:

Learning how to can and cook food the right way
Not feeding honey to babies under 1 year old
Refrigerating oils that have garlic or herbs
Not eating food from a bulging can
Seeking care for wounds
Not using IV drugs

RESOURCES:

Centers for Disease Control and Prevention
https://www.cdc.gov

Food Safety—US Department of Health and Human Services
http://www.foodsafety.gov

CANADIAN RESOURCES:

Canadian Partnership for Consumer Food Safety Education
https://www.fightbac.org/

Public Health Agency of Canada
https://www.canada.ca

References:

Botulism. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/botulism. Accessed February 1, 2021.

Botulism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/botulism. Accessed February 1, 2021.

Botulism. Food Safety—US Department of Health & Human Service website. Available at: https://www.foodsafety.gov/poisoning/causes/bacteriaviruses/botulism/index.html. Accessed February 1, 2021.

Friziero A, Sperti C, et al. Foodborne botulism presenting as small bowel obstruction: a case report. BMC Infectious Diseases, 1/12/2021; 21(1): 1-4.

Infant botulism. Kids Health—Nemours Foundation website. Available at: https://kidshealth.org/en/parents/botulism.html?ref=search. Accessed February 1, 2021.

Botulism. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/botulism. Accessed February 1, 2021.

Last reviewed September 2020 by David L. Horn, MD, FACP
Last Updated: 2/1/2021

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