Recurrent episodes of food borne botulism in a 7-year old boy

ABSTRACT

Botulism is the acute, descending, flaccid paralysis that results when the neurotoxin of Clostridium botulinum blocks neuromuscular transmission. C botulinum toxin is the most poisonous substance that blocks neuromuscular transmission and causes death through airway and respiratory muscle paralysis; all forms of botulism manifest neurologically as asymmetric, descending, flaccid paralysis beginning with the cranial nerve musculature. Food-borne botulism results from the ingestion of food in which C botulinum has multiplied and produced its toxin. We report a new case of food-borne botulism in a 7 year old boy with recurrent episodes of weakness, difficulty in swallowing and speech; bilateral ptosis and mydriasis. He had positive history of the same symptoms, documented twice before. The patient's samples were sent for detection of toxin of Clostridium botulinum, and toxin of C. botulinum, type A was found in his stool sample, confirming our diagnosis. This case was unusual report because our patient has not history of canned food ingestion and also because recurrent episodes of paralysis in this case are unusual findings in botulism. In this report we want to emphasize that canned-food ingestion is not necessary for diagnosis of food-borne botulism and because delayed treatment leads to increase mortality and morbidity, treatment should be initiated promptly on the basis of clinical suspicion