Caldas João Paulo, Filipe Rita, Queirós Rita, Grilo Novais António, Almeida Francisco, Malheiro Luís, Teixeira Lopes Teresa, Saraiva Margarida, Tavares Margarida, Sarmento António
Infectious Diseases Department, Centro Hospitalar Universitário de São João, Portugal.
Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Portugal.
IDCases. 2020 May 25;21:e00839. doi: 10.1016/j.idcr.2020.e00839. eCollection 2020.
Botulism is an acute toxin-mediated neuroparalytic syndrome caused by some species. It typically presents itself as an acute symmetric descending paralysis of cranial and peripheral nerves, which can potentially evolve to respiratory failure and death. We report a case of botulism diagnosed in a patient presenting with a parotitis probably due to xerostomia, even though he had already sought medical assistance for blurred vision and dysphagia. The neurological symptoms resolved without administration of antitoxin and botulism diagnosis was confirmed with identification of both toxins B and F in patient's serum. We aim to illustrate the need for a high clinical suspicion for the diagnosis of botulism and to report an atypical case of botulism with the production of toxins B and F, the latter being of rare occurrence.