Clostridium Botulinum

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History
Clostridium botulinum has a rich history dating back to 19th century Europe where it first contaminated sausages, causing outbreaks of foodborne botulism. (1-3) In fact, the term botulism is derived from the Latin term botulus, meaning sausage. (1,3) Microbiologist Emile Pierre Marie van Ermengem first described the etiologic agent in 1897, (1-3) following isolation of the anaerobic bacillus from ham and splenic tissue obtained upon autopsy. (2,3) Although first referred to as Bacillus botulinus, it was eventually renamed Clostridium botulinum to distinguish it from the aerobic spore-forming genus Bacillus. (2) Importantly, the presence of a toxin was noted at this time, as cell-free extracts were capable of causing disease. (1,2) By 1943 and 1976, wound botulism and infant botulism were also respectively described. (1)

Organism Description
The bacterium Clostridium botulinum is a strict anaerobic Gram-positive bacillus. (1,2,4) A noteworthy feature is the ability to form resistant sub-terminal endospores. (1,4) The species is classified into four different groups, based on physiological, metabolic, and genetic characteristics. (2) Group I strains are proteolytic in culture, produce toxin types A/B/F, and form heat-stable endospores. (1-3) Group II strains are non-proteolytic in culture, produce toxin types B/E/F, and are psychrotrophic. (1-3) Lastly, Group III strains produce toxin types C and D; Group IV strains only produce toxin type G. (1,2) Regardless of group, C. botulinum is not part of the normal gastrointestinal flora; it is exogenously acquired. (2,4)
Botulinum toxin serotypes A and B have been approved for both therapeutic and cosmetic purposes. (1,4) Medical treatment for conditions such as strabismus (...

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...o public health. Weaponization involves aerosolizing the toxin to particles between 1-5µm in diameter (4) which facilitates inhalation of the toxin and access to the lower respiratory tract. (1,4) After the toxin crosses the pulmonary alveolar epithelium, it gains access to the bloodstream and nervous system, causing symptoms similar to foodborne botulism. (1) Thankfully, there have been no major successes in this area because the exposure of the toxin to heat, acid, and ultraviolet light during weapon deployment are likely to degrade its activity. (4) Bioterrorism may also involve contamination of food or beverage supplies within a community, resulting in foodborne botulism. (1)

Conclusion
Clostridium botulinum is an anaerobic bacillus of clinical significance. Although relatively rare, physicians need to be cognizant of its presence and detrimental symptoms.

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