Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.5281/zenodo.4825690
Iberoamerican Journal of Medicine
Case Report

A Rare Case of Botulism in an Adult Patient

Un caso raro de botulismo en una paciente adulta

Deyna Montes-Velez, William Bautista, Samantha Brophy, Justin Chatten-Brown, Leonard Ranasinghe

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Abstract

Presentation of botulism in adults is extremely rare and symptoms can be easily confused for symptoms of acute stroke, Guillain-Barre, or myasthenia gravis. The purpose of this clinical case report is to ensure adult botulism will be included in the differential diagnoses for a patient with this presentation so swift and accurate care can be provided to ensure optimal patient outcome. A 41-year-old-female presented with complaints of sudden onset of difficulty speaking. The patient reports a history of intravenous polysubstance abuse and symptoms progressed to bilateral facial weakness, ptosis, and external ophthalmoplegia. With no notable findings from a non-contrast computed tomography and magnetic resonance imaging and given the symptoms, a diagnosis of wound botulism from intravenous drug use was made. Botulism antitoxin was given and the patient was admitted into the intensive care unit for supportive follow-up care. A colony of Clostridium species was discovered in this patient’s arm and the patient showed significant improvement after a few days of care.

Keywords

Botulism; Botulism antitoxin; Differential diagnosis; Pharmaceutical preparations; Humans; Aftercare

Resumen

La presentación del botulismo en adultos es extremadamente rara y los síntomas pueden confundirse fácilmente con los síntomas de accidente cerebrovascular agudo, Guillain-Barré o miastenia gravis. El propósito de este informe de caso clínico es garantizar que el botulismo del adulto se incluya en los diagnósticos diferenciales de un paciente con esta presentación, de modo que se pueda brindar una atención rápida y precisa para garantizar un resultado óptimo del paciente. Una mujer de 41 años presentó quejas de aparición repentina de dificultad para hablar. El paciente refiere antecedentes de abuso de múltiples sustancias por vía intravenosa y los síntomas progresaron a debilidad facial bilateral, ptosis y oftalmoplejía externa. Sin hallazgos destacables de la tomografía computarizada sin contraste y la resonancia magnética y ante la sintomatología, se realizó el diagnóstico de botulismo de la herida por uso de drogas intravenosas. Se le administró antitoxina de botulismo y la paciente fue ingresada en la unidad de cuidados intensivos para cuidados de seguimiento de apoyo. Se descubrió una colonia de especies de Clostridium en el brazo de esta paciente, mostrando una mejoría significativa después de unos días de atención.

Palabras clave

Botulismo; Antitoxina botulínica; Diagnóstico diferencial; Preparaciones farmacéuticas; Humanos; Cuidados posteriores

References

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Submitted date:
04/25/2021

Reviewed date:
05/09/2021

Accepted date:
05/24/2021

Publication date:
05/27/2021

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