Recurrent bulbar paralysis caused by botulinum toxin type B.

Botulism is a rare, potentially lethal paralytic disease characterized by cranial nerve palsies, descending flaccid muscle paralysis, and possible involvement of the diaphragm and other respiratory muscles. Here, we report, to our knowledge, the first case of recurrent botulism type B in the United States, caused by repetitive ingestion of contaminated homemade hot chili pepper in oil from the same jar.