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Abstract Details

Foodborne Botulism: A Case Report on Home Canning
Infectious Disease
P2 - Poster Session 2 (2:45 PM-3:45 PM)
082

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Botulinum neurotoxin, produced by the bacteria Clostridium Botulinum, is one of the deadliest toxins on the planet attacking the central nervous system by irreversibly binding and blocking the presynaptic release of acetylcholine leading to descending flaccid paralysis and eventual death without intervention. Annually, the United States sees approximately 110 cases of botulism, with around 25% attributed to foodborne transmission.

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This case report details the presentation and diagnosis of foodborne botulism in a 62-year-old male with cerebral palsy and left upper extremity weakness who presented with vomiting and altered mental status. Initial physical exam revealed an unresponsive patient with severe dry eyes that were open, not blinking, pupils midline and sluggishly reactive, intact cough and gag reflex, symmetric withdrawal to pain in all extremities, and persistent desaturations. The patient required mechanical ventilation due to respiratory failure and later developed aspiration pneumonia and septic shock. Initial brain imaging revealed congenital colpocephaly and no evidence of hemorrhage or ischemia. Although the infection resolved and the patient was weaned off sedation, he remained unresponsive, exhibiting a lack of withdrawal to pain in all extremities, loss of brainstem reflexes, and an inability to breathe over the ventilator. Despite extensive testing, including further brain imaging, electroencephalogram, and lumbar puncture, no clear etiology revealed itself until further investigation uncovered that the patient canned/jarred his own foods at home, a known source for foodborne botulism. Upon consultation with the Los Angeles Health Department, the patient received the botulinum antitoxin (BAT) and symptomatic support until return to baseline.

Recognizing signs of botulism is crucial despite its rarity. A thorough history helps identify potential sources of infection and transmission. Early intervention, including mechanical ventilation and prompt administration of botulinum antitoxin is vital in reducing risk of fatal outcomes.

Authors/Disclosures
Melissa Kreutz
PRESENTER
Ms. Kreutz has nothing to disclose.
Naqeeya Sabuwala No disclosure on file
Emanuela R. Sofroni, MD (Vascular Neurology of SoCal) Dr. Sofroni has nothing to disclose.