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- Title
Long lasting dysautonomia due to botulinum toxin B poisoning: clinicallaboratory follow up and difficulties in initial diagnosis.
- Authors
Potulska-Chromik, Anna; Pniewska, Beata Zakrzewska; Lewandowski, Jacek; Si¿ski, Maciej; Przyja¿kowski, Witold; Pruszczyk, Anna Kostera; Sałkowska, Elzbieta Szmidt
- Abstract
Background Botulism is an acute form of poisoning caused by one of four types (A, B, E, F) toxins produced by Clostridium botulinum, ananaerobic, spore forming bacillus. Usually diagnosis of botulism is considered in patients with predominant motor symptoms: muscle weakness with intact sensation and preserved mental function. Case presentation We report a case of 56-year-old Caucasian female with a history of arterial hypertension, who presented with acute respiratory failure and bilateral ptosis misdiagnosed as brainstem ischemia. She had severe external and internal ophtalmoplegia, and autonomic dysfunction with neither motor nor sensory symptoms from upper and lower limbs. Diagnosis of botulinum toxin poisoning was made and confirmed by serum antibody testing in the mouse inoculation test. Conclusions Ophtalmoplegia, autonomic dysfunction and respiratory failure can be caused by botulism. Early treatment and intensive care is essential for survival and recovery. The electrophysiological tests are crucial to correct and rapid diagnosis. Botulism (especially type B) should be considered in any case of acute or predominant isolated autonomic dysfunction.
- Subjects
BOTULISM diagnosis; BOTULINUM toxin; MUSCLE weakness; DYSAUTONOMIA; RESPIRATORY insufficiency
- Publication
BMC Research Notes, 2013, Vol 6, Issue 1, p1
- ISSN
1756-0500
- Publication type
Article
- DOI
10.1186/1756-0500-6-438