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Botulism disguised as parotitis.

João Paulo Caldas1, Rita Filipe1, Rita Queirós2

  • 1Infectious Diseases Department, Centro Hospitalar Universitário de São João, Portugal.

Idcases
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Summary

This case highlights an unusual presentation of botulism (a neuroparalytic syndrome) with parotitis. Early clinical suspicion is crucial for diagnosing this rare toxin-mediated illness.

Keywords:
BotulismNeurotoxinParotitis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Toxicology

Background:

  • Botulism is a severe neuroparalytic illness caused by toxins from Clostridium species.
  • It typically manifests as descending paralysis, potentially leading to respiratory failure.

Observation:

  • A patient presented with parotitis, blurred vision, and dysphagia, initially masking botulism.
  • Neurological symptoms resolved spontaneously without antitoxin therapy.

Findings:

  • The diagnosis of botulism was confirmed by detecting both botulinum toxin B and the rare toxin F in the patient's serum.
  • This case involved an atypical presentation and the co-production of two distinct botulinum toxins.

Implications:

  • Emphasizes the importance of maintaining a high index of clinical suspicion for botulism, even with unusual symptoms.
  • Reports a rare instance of botulism involving co-production of toxins B and F, underscoring diagnostic challenges.