Editing Botulism (section)

== Diagnosis ==
For botulism in babies, diagnosis should be made on signs and symptoms. Confirmation of the diagnosis is made by testing of a [[stool test|stool]] or [[enema]] specimen with the mouse [[bioassay]].

In people whose history and physical examination suggest botulism, these clues are often not enough to allow a diagnosis. Other diseases such as [[Guillain–Barré syndrome]], [[stroke]], and [[myasthenia gravis]] can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include a [[brain scan]], [[cerebrospinal fluid]] examination, nerve conduction test ([[electromyography]], or EMG), and an [[edrophonium]] chloride (Tensilon) test for [[myasthenia gravis]]. A definite diagnosis can be made if botulinum toxin is identified in the food, stomach or intestinal contents, vomit or feces. The toxin is occasionally found in the blood in [[peracute]] cases. Botulinum toxin can be detected by a variety of techniques, including [[enzyme-linked immunosorbent assay]]s (ELISAs), [[electrochemiluminescent]] (ECL) tests and mouse inoculation or feeding trials. The toxins can be typed with neutralization tests in mice. In toxicoinfectious botulism, the organism can be cultured from tissues. On egg yolk medium, toxin-producing colonies usually display surface iridescence that extends beyond the colony.<ref>{{cite book| vauthors = Weber JT |chapter=Botulism |title=Infectious Diseases |edition=5th | veditors = Hpeprich PD |publisher=[[J. B. Lippincott & Co.|J. B. Lippincott Company]] |date=1994 |pages=1185–94}}</ref>