[Botulism caused by consumption of smoked salmon]

Fresh fish products are exquisitely prone to be the source for food botulism because of primary contamination with Clostridium botulinum spores, lack of heat inactivation of C. botulinum spores, frequently used air-tight packaging, lack of preservatives, lack of heat inactivation of already produced botulinum toxin and because of substantial low temperature resistance of C. botulinum type E typically found in fish botulism. We can reporting a 25-year-old patient with food botulism presenting with an anticholinergic syndrome with mydriasis, accommodation difficulties, dryness of mouth, reduced sweating, constipation and reduced heart rate variance and only discrete involvement of striate muscles with ptosis, diplopia and generalised fatigue, all of which developed 12 h after the consumption of airtight sealed smoked salmon. The salmon was consumed 3 days after the 'use by' date had expired.