“…Classically, botulism has an acute presentation 4 , and its spectrum includes four main types of naturally occurring disease, numbered as follows: intestinal (or hidden) infection with in situ production of toxins; this is most commonly reported in infants (I), than in adults (II); wound botulism (III); the disease caused by contaminated food, the so-called foodborne botulism (IV) which is characterized by the ingestion of preformed toxins 2 , 3 , 5 , 6 . Two other forms of the disease are represented by (V) iatrogenic botulism, during the use of botulinum toxin either for therapeutic or cosmetic indications, and (VI) inhalation botulism, caused by aerosolized toxins 7 , 8 . Adult intestinal toxemia botulism (II), also called infant-like botulism 9 , is the rarest form 10 , characterized by the ingestion of spores, their intestinal germination and the intraluminal production of neurotoxins 1 , 9 , 11 , 12 .…”