Serum and stool tested negative for botulinum toxin, but several jars of canned spaghetti sauce with peas and meat, tested positive for high levels of botulinum toxin A and B. Labs were unremarkable for both patients initially, as were imaging studies (CT, MRI) and lumbar puncture.
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ACEP Now: Vol 33 – No 10 – October 2014My patient avoided intubation and is still recovering slowly several months out but doing well. His wife was eventually intubated and had a prolonged ICU course, requiring tracheostomy and percutaneous endoscopic gastrostomy tube placement. She has been oscillating between the nursing home and the hospital for respiratory issues and recurrent pneumonia.
Dr. Hodson is an attending physician at Albany Memorial Hospital, Emergency Medicine Physicians, in Albany, New York.
References
- MacDonald KL, Cohen ML, Blake PA. The changing epidemiology of adult botulism in the United States. Am J Epidemiol. 1986;124:794-799.
- Woodruff BA, Griffin PM, McCroskey LM, et al. Clinical and laboratory comparison of botulism form toxin Types A, B, E, in the United States 1975-1988. J Infect Dis. 1992;166:1281-1286.
- Centers for Disease Control and Prevention. Summary of botulism cases reported in 2012. Available at: http://www.cdc.gov/nationalsurveillance/PDFs/Botulism_CSTE_2012.pdf. Accessed August 28, 2014.
- Geyer H. Botulism. In: Nelson LS, Lewin NA, Howland MA, et al, eds.. Goldfrank’s toxicological emergencies. 9th ed. New York: McGraw-Hill Medical; 2011:682-697.
- Shantz EJ, Johnson EA. Properties and use of botulinum antitoxin and other microbial neurotoxins in medicine. Microbiol Rev. 1992;56:80-99.
- Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance—recommendations and report. MMWR Morb Mortal Wkly Rep. 1997;46(RR10):1-55.
- MacDonald KL, Spengler RF, Hatheway C, et al. Type A botulism from sauteed onions; clinical and epidemiologic observations. JAMA. 1985;253:1275-1278.
- Smith LDS. The occurrence of Clostridium botulinum and Clostridium tetani in the soil of the United States. Health Lab Sci. 1978;15:74-80.
- Wilcox P, Andofatto G, Fairbain MS, et al. Long-term follow-up of symptoms, pulmonary function, respiratory muscle strength, and exercise performance after botulism. Am Rev Respir Dis. 1989;139:157-163.
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