Commentary: Where Marco Polo Meets Meckel: Type E Botulism from Clostridium butyricum

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Abstract
The most potent poison known, lethal to man in nanogram amounts, is botulinum neurotoxin. Until a generation ago, botulism was recognized almost exclusively as the result of ingesting botulinum neurotoxin in preserved food contaminated by Clostridium botulinum [2]. Botulism had rarely occurred from infected wounds in analogy to tetanus [3]. The victims of botulism were usually adults. Of the 7 serologically distinct types of botulinum neurotoxin, nearly all human cases were caused by types A, B, or E. Type E botulism, with rare exception [4], was associated with eating fish or other aquatic animals [5].