Foodborne Botulism Type F: A Rare Presentation of Neurologic Manifestation and Successful Management

Botulism is a neuroparalytic syndrome resulting from the systemic effects of an exoneurotoxin produced by gram-positive, rod-shaped, spore-forming, obligate anaerobic bacterium Clostridium botulinum. Here, we present the case of a 40-year-old male, presenting with a sudden onset of abdominal pain associated with vomiting. He was admitted for conservative management once the CT of the abdomen and pelvis revealed partial small bowel obstruction with no signs of bowel perforation or ischemia. However, the next day, the patient had a cardiac arrest thought to be secondary to respiratory arrest. The return of spontaneous circulation was achieved after two cycles of cardiopulmonary resuscitation. The patient developed quadriplegia, areflexia, and bilateral ophthalmoplegia. He was empirically treated with pyridostigmine, intravenous immunoglobulin (IVIG), and botulinum antitoxin. Stool polymerase chain reaction (PCR) testing resulted positive for C. botulinum toxin type F. The patient ultimately recovered with botulinum antitoxin and a month of physical and speech therapy. Our case highlights that clinicians should consider botulism as a differential and emphasize the importance of early diagnosis for effective management and prognosis.