Bladder Paralysis Due to Foodborne Botulinum Toxin Type B

Foodborne botulism is a rare toxi-infection in France (20 to 30 cases per year).(1) Incubation time is comprised between few hours to 8 days. Clostridium botulinum is ananaerobic gram-positive organism which is ubiquitously found in soil and aquatic sediments in the spore form. Several forms of botulism exist. The foodborne form is the most frequent in the human botulism. Clostridium botulinum produces 7 different toxins of typeA, B, C, D, E, F, and G. Toxin type A is the most frequent and is found in the home-canned. Toxin type B is found in the cooked pork meats. All forms of botulism producethe same clinical symptoms: symmetrical cranial nerve palsies followed by descending, flaccid paralysis of voluntary muscles, which may progress to respiratory arrest. Prominent autonomic symptoms include accommodative paralysis with mydriasis, anhydrosis with severe dry mouth and throat, and orthostatic hypotension. Constipation and bladder paralysis are rarely reported.(2) All toxins exert their action on the cholinergic system at the presynaptic motorneuron terminal by blocking acetylcholine transmission across the neuromuscular junction. It causes neuromuscular blockade, resulting in a flaccid paralysis.(3) This article describes a caseof a 43-year-old man who presented with severe botulismmanifestations. In addition to the severe cranial motor nerves paralysis, a complete bladderparalysis was observed.