Foodborne Botulism Presenting With Isolated Cranial Nerve Involvement in a Young Adult

A young man presented with progressive cranial nerve dysfunction following participation in a communal meal. Initial investigations and imaging were inconclusive; Guillain-Barré syndrome and viral encephalitis were considered in the differential diagnosis. He was admitted to the intensive care unit (ICU) due to the potential need for respiratory support. The progression of neurological dysfunction, combined with relevant dietary exposure, raised clinical suspicion for botulism. The patient was treated with heptavalent botulinum antitoxin, and serum testing later confirmed the presence of botulinum toxin type A. With multidisciplinary supportive care, he fully recovered without requiring mechanical ventilation. This case highlights the importance of early recognition of bulbar symptoms, the timely administration of empirical antitoxin therapy, and the role of ICU monitoring. It also underscores how non-specific early symptoms can delay diagnosis and emphasizes the need for high clinical suspicion in otherwise healthy young patients.