An 18-year-old woman has eaten homemade preserves. Eighteen hours later, she develops diplopia, dysarthria, and dysphagia. Which of the following is the most likely causative organism?: (A) Clostridium botulinum toxin, (B) staphylococcal toxin, (C) salmonellosis, (D) brucellosis
Answer is A. The incubation period of C. botulinum toxin is 18-36 hours but ranges from a few hours to days. There are no sensory symptoms. Foodborne botulinum is associated primarily with home-canned food. Severe foodborne botulinum can produce diplopia, dysarthria, and dysphagia; weakness then can progress rapidly to involve the neck, arms, thorax, and legs. There is usually no fever. Nausea, vomiting, and abdominal pain can precede the paralysis or come afterward.