title: [Botulism has not disappeared].
abstract: BACKGROUND
  Botulism is a potentially fatal infectious disease induced by a neurotoxin secreted by Clostridium botulinum, a sporulated species of obligate anaerobic bacteria. This neurotoxin inhibits the normal release of acetylcholine in the synaptic cleft, inducing presynaptic neuromuscular blockade. The diagnosis is often difficult because of the range and the lack of specificity of the symptoms.
  
  
  METHODS
  We report two cases of human botulism. The first case was easy to diagnose, with dysphagia, dysphonia, blurred vision, and xerostomia, associated with potentiation on electromyogram and B botulinum toxin in the serum. Symptoms in the second case included diplopia, blurred vision, dysphagia, dysphonia, with potentiation on electromyogram but no botulinum toxin.
  
  
  CONCLUSIONS
  These two cases remind us of the necessity to keep botulism in mind when systemic atropinic symptoms are found together with generalized, progressive and extensive paralysis. The diagnosis is confirmed by electromyogram and serology. There is no specific treatment for botulism; only intensive care surveillance and symptomatic treatment improve survival.
authors.affiliation: Service de neurologie, CHU de Dijon, F-21000 Dijon, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gentil
authors.forename: Pierre
authors.initials: P
authors.lastname: Soichot
authors.forename: Cécile
authors.initials: C
authors.lastname: Maugras
authors.forename: Martine
authors.initials: M
authors.lastname: Lemesle-Martin
authors.forename: Yannick
authors.initials: Y
authors.lastname: Béjot
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouaud
authors.forename: Guy-Victor
authors.initials: GV
authors.lastname: Osseby
authors.forename: Agnès
authors.initials: A
authors.lastname: Fromont
authors.forename: Grégory
authors.initials: G
authors.lastname: Couvreur
authors.forename: Thibault
authors.initials: T
authors.lastname: Moreau
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
mesh_terms: D000328:Adult; D001905:Botulinum Toxins / Q000097:blood; D001906:Botulism / Q000175:diagnosis*; D003680:Deglutition Disorders / Q000382:microbiology; D004576:Electromyography; D006801:Humans; D008297:Male; D014786:Vision Disorders / Q000382:microbiology; D014832:Voice Disorders / Q000382:microbiology; D014987:Xerostomia / Q000382:microbiology
chemical_list: D001905:Botulinum Toxins