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Botulism is a rare, life‐threatening disease caused by neurotoxins produced by C. botulinum (and rarely, by Clostridium baratii and Clostridium butyricum). C. botulinum is a ubiquitous gram‐positive, spore‐forming obligate anaerobic bacterium. Its spores germinate under conditions such as in improperly processed, canned, low acid or alkaline foods where anaerobic conditions have occurred. Botulin toxins are extremely potent; they induce paralysis by binding to presynaptic acetylcholine receptors and preventing neurotransmitter release. Toxins A, B, E and F cause disease in humans, with toxin A associated with the most severe toxidrome. Common routes of exposure include ingestion (foodborne botulism), colonisation of a wound (wound botulism), the intestines (infant botulism), and via high concentration cosmetic or therapeutic injections of toxin (iatrogenic botulism). Inhalational botulism has also occurred among laboratory workers.

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Authors: Chris Kwan, Anthony Elias, Katherine Todd, Celia Bradford, Joshua Smith, Indira Datta, Jimmy Ng, Katie Kelleway, Jessica Butler, Sarah Webb and Michal Lubomski

Article Type: Medical Education