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

ObjectiveBotulism 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.PatientWe report a new case of food-borne botulism in a 7 year old boy with recurrentepisodes of weakness, difficulty in swallowing and speech; bilateral ptosis andmydriasis. He had positive history of the same symptoms, documented twicebefore. The patient’s samples were sent for detection of toxin of Clostridiumbotulinum, and toxin of C. botulinum, type A was found in his stool sample,confirming our diagnosis. This case was unusual report because our patient hasnot history of canned food ingestion and also because recurrent episodes ofparalysis in this case are unusual findings in botulism.ConclusionIn this report we want to emphasize that canned-food ingestion is not necessaryfor diagnosis of food-borne botulism and because delayed treatment leads toincrease mortality and morbidity, treatment should be initiated promptly on thebasis of clinical suspicion.