Abstract
Botulism is a rare disease caused by Clostridium botulinum neurotoxin that irreversibly blocks releasing of acetylcholine on presynaptic cholinergic terminal of the autonomic nerves of the neuromuscular junction. Intoxication is most commonly reported in association with consumption of homemade canned or smoked products. Botulism is usually described as a potentially lethal disease, however, because the clinical presentation is dose-dependent, in some cases this disease can have a mild course and poorly defined symptoms. We present clinical findings of a 26 year old male patient who developed constipation, urine retention, blurred vision and weakness, after eating a homemade smoked ham. Our patient had mild form of botulism with no signs of respiratory distress and his treatment included only symptomatic measures. Laboratory diagnosis of botulism was obtained by the mouse bioassay (MBA) test which confirmed the presence of botulinum neurotoxin in the patient’s serum. The diagnosis of botulism is frequently missed or delayed in patients with mild clinical presentations because of the sporadic nature of cases and general unfamiliarity with the syndrome.
Highlights
Botulism is a rare but potentially life-threatening disease caused by accidental or intentional exposure to botulinum toxins
The toxin acts on the nervous system by inhibiting release of acetylcholine, inducing flaccid paralysis
Botulism classically manifests as a distinct clinical syndrome of symmetrical cranial nerve palsies that may be followed by descending, symmetric flaccid paralysis of voluntary muscles, which may progress to respiratory compromise and death [4]
Summary
Botulism is a rare but potentially life-threatening disease caused by accidental or intentional exposure to botulinum toxins. In the clinical status bilateral ptosis was prominent, the pupils were symmetrically enlarged and a lack of the pupillary light reflex and the accommodation reflex were found, along with a terminal horizontal bilateral nystagmus He had visited an ophthalmologist three times complaining of vision disturbances without the diagnosis of botulism being considered. His oral mucous membranes were extremely dry and he complained of severe dryness of the mouth and the throat, accompanied by difficult swallowing, which was interpreted as symptomatic of anhydrosis, a clinical manifestation of autonomic nervous system dysfunction. The mouse bioassay (MBA) was used to confirm the tentative clinical diagnosis of botulism by intraperitoneal injection of the patient’s serum into mice unprotected and protected with polyvalent botulinum antitoxin, followed by observation of the development of botulism-specific symptoms in the animals. At follow-up 3 and 6 months later his neurological examinations were completely normal
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
