{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T20:47:23Z","timestamp":1780433243927,"version":"3.54.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the clinical presentations, and therapeutic principles of botulism, with the goal of improving physicians\u2019 understanding of the condition and refining treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective analysis was carried out on the clinical data of 8 patients with botulism, encompassing age, gender, etiology, delay diagnosis time, course of disease, clinical manifestations, auxiliary examinations, and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 8 cases, 5 were female and 3 male, with the age ranging from 14 to 60\u202fyears. 5 cases were of iatrogenic poisoning, and 3 were of foodborne poisoning. Besides the classical clinical manifestations, some patients had atypical symptoms like intestinal obstruction, unilateral involvement, and consciousness disorder. Among the 8 cases, 6 had abnormal electrophysiological examination results. 6 patients had a delayed diagnosis of over 7\u202fdays, with disease course from 7 to 115\u202fdays, and 7 received treatment. All patients received symptomatic and supportive treatment. Moreover, 4 received invasive respiratory support, 3 received intravenous immunoglobulin injection, 1 received plasma exchange therapy, and 1 received antitoxin therapy. All patients were discharged with normal cranial nerve function, gastrointestinal function, muscle strength, and tone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with botulism may exhibit atypical clinical symptoms, necessitating heightened vigilance from physicians. Neurophysiological studies are integral to the diagnostic process. Furthermore, symptomatic supportive treatment is essential for patients whose diagnosis has been delayed beyond 7\u202fdays. In conclusion, a comprehensive understanding of the clinical features, differential diagnostic criteria, and therapeutic options for botulism is essential for reducing disease duration, optimizing patient outcomes, and enhancing treatment efficacy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1574807","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T05:25:31Z","timestamp":1744003531000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comprehensive analysis of partial confounding clinical symptoms and treatment options of botulism: a case series"],"prefix":"10.3389","volume":"16","author":[{"given":"Xuanyu","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiping","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1124\/pr.116.012658","article-title":"Botulinum neurotoxins: biology, pharmacology, and toxicology","volume":"69","author":"Pirazzini","year":"2017","journal-title":"Pharmacol Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1365-2958.1994.tb00396.x","article-title":"Mechanism of action of tetanus and botulinum neurotoxins","volume":"13","author":"Montecucco","year":"1994","journal-title":"Mol Microbiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"470","DOI":"10.3390\/ijms21249470","article-title":"An integrated pharmacophore\/docking\/3D-QSAR approach to screening a large library of products in search of future botulinum neurotoxin a inhibitors","volume":"21","author":"Gentile","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1093\/cid\/cix935","article-title":"Clinical characteristics and ancillary test results among patients with botulism-United States, 2002-2015","volume":"66","author":"Rao","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7002a1","article-title":"Clinical guidelines for diagnosis and treatment of botulism, 2021","volume":"70","author":"Rao","year":"2021","journal-title":"MMWR Recomm Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e365","DOI":"10.1212\/CPJ.0000000000000814","article-title":"Botulism mimicking miller fisher syndrome","volume":"11","author":"Sicurella","year":"2021","journal-title":"Neurol Clin Pract"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1002\/jca.22081","article-title":"Botulism mimicking Guillain-Barre syndrome: the question of plasma exchange in an unusual case of acute paralysis","volume":"38","author":"Silva Campos","year":"2023","journal-title":"J Clin Apher"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1674","DOI":"10.1086\/599030","article-title":"Diagnosis and treatment of botulism: a century later, clinical suspicion remains the cornerstone","volume":"48","author":"Sobel","year":"2009","journal-title":"Clin Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"338","DOI":"10.3390\/toxins12050338","article-title":"Human botulism in France, 1875-2016","volume":"12","author":"Rasetti-Escargueil","year":"2020","journal-title":"Toxins"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1001\/jama.2023.8085","article-title":"What is botulism?","volume":"330","author":"Jin","year":"2023","journal-title":"JAMA"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"788","DOI":"10.46234\/ccdcw2022.114","article-title":"Epidemiological analysis of foodborne botulism outbreaks - China, 2004-2020","volume":"4","author":"Li","year":"2022","journal-title":"China CDC Wkly"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"S38","DOI":"10.1093\/cid\/cix814","article-title":"Clinical criteria to trigger suspicion for botulism: an evidence-based tool to facilitate timely recognition of suspected cases during sporadic events and outbreaks","volume":"66","author":"Rao","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/s0300-9084(00)00216-9","article-title":"How botulinum and tetanus neurotoxins block neurotransmitter release","volume":"82","author":"Humeau","year":"2000","journal-title":"Biochimie"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1001\/archneur.1982.00510130057015","article-title":"Botulism: a case with associated sensory abnormalities","volume":"39","author":"Goode","year":"1982","journal-title":"Arch Neurol"},{"key":"ref15","first-page":"477","article-title":"Botulism with sensory symptoms diagnosed by neuromuscular transmission studies associated with edrophonium responsiveness","volume":"36","author":"Kuruo\u011flu","year":"1996","journal-title":"Electromyogr Clin Neurophysiol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1136\/jnnp.54.9.844","article-title":"Botulism with sensory symptoms: a second case","volume":"54","author":"Mart\u00ednez-Castrillo","year":"1991","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"442","DOI":"10.7326\/0003-4819-95-4-442","article-title":"Clinical features of types a and B food-borne botulism","volume":"95","author":"Hughes","year":"1981","journal-title":"Ann Intern Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2205251","DOI":"10.1080\/21505594.2023.2205251","article-title":"Pathogenicity and virulence of Clostridium botulinum","volume":"14","author":"Rawson","year":"2023","journal-title":"Virulence"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e1003087","DOI":"10.1371\/journal.ppat.1003087","article-title":"Botulinum neurotoxins a and E undergo retrograde axonal transport in primary motor neurons","volume":"8","author":"Restani","year":"2012","journal-title":"PLoS Pathog"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e0207448","DOI":"10.1371\/journal.pone.0207448","article-title":"Brain functional changes in patients with botulism after illegal cosmetic injections of botulinum toxin: a resting-state fMRI study","volume":"13","author":"Li","year":"2018","journal-title":"PLoS One"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.1212\/CON.0000000000001205","article-title":"Lambert-Eaton Myasthenic syndrome and botulism","volume":"28","author":"Raja","year":"2022","journal-title":"Continuum (Minneapolis, Minn)"},{"key":"ref22","first-page":"S28","article-title":"Electrophysiologic methods as an aid in diagnosis of botulism: a review","volume":"5","author":"Cherington","year":"1982","journal-title":"Muscle Nerve"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1097\/00004691-199304000-00004","article-title":"Clinical neurophysiology of disorders of the neuromuscular junction","volume":"10","author":"Sanders","year":"1993","journal-title":"J Clin Neurophysiol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1001\/archinte.1983.00350030061012","article-title":"Early and late pulmonary complications of botulism","volume":"143","author":"Schmidt-Nowara","year":"1983","journal-title":"Arch Intern Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1136\/practneurol-2014-000937","article-title":"Mimics and chameleons in Guillain-Barr\u00e9 and miller fisher syndromes","volume":"15","author":"Wakerley","year":"2015","journal-title":"Pract Neurol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1136\/jnnp-2013-305397","article-title":"Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome","volume":"85","author":"Wakerley","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1093\/cid\/cix827","article-title":"Workgroup report by the joint task force involving American Academy of Allergy, Asthma & Immunology (AAAAI); food allergy, anaphylaxis, dermatology and drug allergy (FADDA) (adverse reactions to foods committee and adverse reactions to drugs, biologicals, and latex committee); and the Centers for Disease Control and Prevention botulism clinical treatment guidelines workgroup-allergic reactions to botulinum antitoxin: a systematic review","volume":"66","author":"Schussler","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"S57","DOI":"10.1093\/cid\/cix816","article-title":"Safety and improved clinical outcomes in patients treated with new equine-derived heptavalent botulinum antitoxin","volume":"66","author":"Yu","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1093\/cid\/cix812","article-title":"Pediatric botulism and use of equine botulinum antitoxin in children: a systematic review","volume":"66","author":"Griese","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"S43","DOI":"10.1093\/cid\/cix815","article-title":"Efficacy of antitoxin therapy in treating patients with foodborne botulism: a systematic review and Meta-analysis of cases, 1923-2016","volume":"66","author":"O'Horo","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1016\/0002-9343(84)90988-4","article-title":"Equine antitoxin use and other factors that predict outcome in type a foodborne botulism","volume":"76","author":"Tacket","year":"1984","journal-title":"Am J Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/phar.2068","article-title":"Disaster preparedness: biological threats and treatment options","volume":"38","author":"Narayanan","year":"2018","journal-title":"Pharmacotherapy"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"269","DOI":"10.5694\/j.1326-5377.1992.tb137135.x","article-title":"Severe botulism after eating home-preserved asparagus","volume":"157","author":"Paterson","year":"1992","journal-title":"Med J Aust"},{"key":"ref34","first-page":"332","article-title":"Treatment of botulism with guanidine","volume":"198","author":"Ricker","year":"1970","journal-title":"Z Neurol"},{"key":"ref35","first-page":"379","article-title":"Human type a botulism and treatment with 3,4-diaminopyridine","volume":"32","author":"Davis","year":"1992","journal-title":"Electromyogr Clin 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