[Type E botulism. Two recent cases (author's transl)]

Two brothers, aged 29 and 31, developed severe type E botulism 12 hours after eating salted herrings. The younger died rapidly, the other survived after treatment with type E botulinus antitoxin under intensive care. Limited electromyographic exploration of the surviving patient showed characteristic signs of presynaptic block. This method may be helpful in the diagnosis of atypical forms of the disease. Type E botulism is uncommon in France. It is almost exclusively transmitted by raw, smoked or salted fish and, for some obscure reason, rarely affects all those who shared the same meal. Contrary to types A and B botulism, it usually responds to its specific antitoxin, which must be administered as early as possible. The other therapeutic measures (tracheostomy, controlled ventilation, tube feeding) are the same for all types.