Adult Colonization Botulism in Crohn’s Disease

Don’t Panic; Just be Cautious

In 2007, doctors in Ontario disclosed three cases of adult colonization botulism, an extremely uncommon disease caused by a toxin produced by the spore-forming bacterium Clostridium botulinum. Of specific concern is that all three of these patients also had Crohn’s disease, which appears to increase susceptibility to the bacterium. Two cases occurred in November 2006 and one in February 2007.

There are four categories of botulism affecting humans: foodborne, wound, and colonization in both infants and adult. Cases of foodborne botulism are so rare in Canada that we tend to forget that the spores of C. botulinum are everywhere and that its neurotoxin is the most potent lethal substance known.

We must stress that there have been only 10 cases of adult colonization botulism reported worldwide in more than 30 years. However, to be extra cautious, we advise patients with Crohn’s disease to consult a medical professional immediately if any of the following symptoms occur: vomiting, diarrhea, nausea, fatigue, muscular weakness or the more severe neurological symptoms of drooping eyelids, fixed and dilated pupils, blurred vision, double vision, difficulty swallowing, and difficulty speaking.

Staff Writers
First published in The Inside Tract® Newsletter Issue 161 May/June 2007

References:

1. C. botulinum. Health Canada http://www.hc-sc.gc.ca/fn-an/alt_formats/pdf/legislation/pol/sop-cbot-eng.pdf Last accessed August 4, 2011
2. Botulism in Canada. Canadian Medical Association Journal. 2001;164(4):538
3. A H Hauschild, L Gauvreau. Food-borne botulism in Canada, 1971-84. Canadian Medical Association Journal. 1985;133(11):1141–1146