A Case of Atypical Intestinal Botulism With Rapid Recovery After Delayed Antitoxin Administration

Botulism classically manifests with descending flaccid paralysis progressing to possible respiratory failure. Atypical presentations often have symptomatic overlap with other neuromuscular junction pathologies, making it difficult to diagnose and treat quickly. Here we present the case of a 31-year-...

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Bibliographic Details
Main Authors: Alexander Chiang, Shawn Cho, Panhaneath Seng, Shireen Mirza
Format: Article
Language:English
Published: American College of Physicians 2024-05-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.0634
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Summary:Botulism classically manifests with descending flaccid paralysis progressing to possible respiratory failure. Atypical presentations often have symptomatic overlap with other neuromuscular junction pathologies, making it difficult to diagnose and treat quickly. Here we present the case of a 31-year-old woman hospitalized 6 days after elective abdominoplasty for dysphagia, bilateral ptosis, and upper extremity weakness who, despite delayed initiation of antitoxin therapy on day 14, showed rapid muscle tone recovery within 48 hours of administration. This case discusses the variable manifestation of botulism which leads to difficulty in diagnosis, and emphasizes the possibility of rapid recovery and even paralysis reversal despite delayed antitoxin administration.
ISSN:2767-7664