Page "Botulism" Paragraph 21

Physicians may consider diagnosing botulism if the patient's history and physical examination suggest botulism.

However, these clues are often not enough to allow a diagnosis.

Other diseases such as Guillain-Barré syndrome, stroke, and myasthenia gravis can appear similar to botulism, and special tests may be needed to exclude these other conditions.

These tests may include a brain scan, cerebrospinal fluid examination, nerve conduction test ( electromyography, or EMG ), and an edrophonium chloride ( Tensilon ) test for myasthenia gravis.

A definite diagnosis can be made if botulinum toxin is identified in the food, stomach or intestinal contents, vomit or feces.

The toxin is occasionally found in the blood in peracute cases.

Botulinum toxin can be detected by a variety of techniques, including enzyme-linked immunosorbent assays ( ELISAs ), electrochemiluminescent ( ECL ) tests and mouse inoculation or feeding trials.

The toxins can be typed with neutralization tests in mice.

In toxicoinfectious botulism, the organism can be cultured from tissues.

On egg yolk medium, toxin-producing colonies usually display surface iridescence that extends beyond the colony.