The otolaryngologic presentation of botulism

Botulism, although an uncommon disease, may nonetheless present to the otolaryngologist. The clinical signs of a severely erythematous, parched tongue, oropharynx, hypopharynx and larynx, especially when associated with bilateral cranial nerve deficits, should arouse suspicion of this disorder. Once the presumptive diagnosis of botulism is made, the otolaryngologist should expeditiously act to ensure appropriate airway control, as respiratory collapse may be imminent.