Noninfantile Acquired Botulism

Older children and adults acquire botulism through poorly cooked, contaminated food with the toxin or through a cutaneous wound that becomes contami­nated with soil-containing Clostridium botulinum. The toxin can often be identified in the serum and the food source. Clinical findings include acute onset of consti­pation, ptosis, diplopia, bulbar weakness, respiratory difficulties, ophthalmoparesis, pupillary dilation, and diminished deep tendon reflexes. Recovery may take months. The diagnosis is generally made from elec­trodiagnostic studies.