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Identification of the offending toxin in the patient’s serum, stool, or gastric content or in the suspected food confirms the diagnosis. An electromyogram showing diminished muscle action potential after a single supramaximal nerve stimulus is also diagnostic.
Diagnosis also must rule out other diseases often confused with botulism, such as Guillain-Barré syndrome, myasthenia gravis, cerebrovascular accident, staphylococcal food poisoning, tick paralysis, chemical intoxication, carbon monoxide poisoning, fish poisoning, trichinosis, and diphtheria.
Source: Handbook of Diseases, 2003
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