Diagnosis and Treatment of Botulism

Publication Date: May 7, 2021
Last Updated: November 27, 2023


Consider botulism when myasthenia gravis or Guillain-Barré syndrome are suspected and in a patient with unexplained symmetric cranial nerve palsies, with or without paresis of other muscles.

Conduct thorough, serial neurologic examinations to detect the neurologic deficits of botulism and their progression.

If botulism is suspected, immediately contact the local or state health department’s emergency on-call staff to arrange an emergency expert clinical consultation and, when indicated, request botulinum antitoxin from CDC.

Recommendation Grading




Diagnosis and Treatment of Botulism

Authoring Organization

Publication Month/Year

May 7, 2021

Last Updated Month/Year

August 15, 2023

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Childcare center, Emergency care, Hospital

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Diagnosis, Assessment and screening, Treatment

Diseases/Conditions (MeSH)

D001906 - Botulism


Botulism, cranial nerve palsies, neurotoxin-mediated, flaccid, Botulinum neurotoxin, Clostridium botulinum

Source Citation

Rao AK, Sobel J, Chatham-Stephens K, Luquez C. Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021. MMWR Recomm Rep. 2021 May 7;70(2):1-30. doi: 10.15585/mmwr.rr7002a1. PMID: 33956777; PMCID: PMC8112830.