Pauci-symptomatic foodborne botulism due to Clostridium botulinum type B with predominant ophthalmologic presentation possibly after consumption of honey. 2022

Paul Goin, and Beate Hagenkötter, and Vincent Gendrin, and Pauline Garnier, and Timothée Klopfenstein, and Souheil Zayet
Ophthalmology Department, Nord Franche-Comté Hospital, France. Electronic address: paulgoin51@gmail.com.

Foodborne botulism, a toxin-mediated illness caused by Clostridium botulinum, is a public health emergency, and rarely reported in France. We report herein the case of two family members (a father and his son) from Franche-Comté, France, presented with ophthalmological symptoms which occurred after non-specific gastro-intestinal symptoms after a trip to Serbia with a recent consumption of artisanal honey, and suggestive of botulism. The suspected intoxication appeared to be caused by a type B strain of C. botulinum, as demonstrated by toxin-neutralization in the lethal mouse bioassay. Regarding the mild-to-moderate form, the patients were treated symptomatically with monitoring, against antitoxins, with no evidence of relapse afterwards. We want to highlight the importance of recognizing clinical ophthalmologic botulism symptoms as unreactive bilateral mydriasis with lack of accommodation to contribute to earlier diagnosis in case of pauci-symptomatic botulism.

UI MeSH Term Description Entries
D001906 Botulism A disease caused by potent protein NEUROTOXINS produced by CLOSTRIDIUM BOTULINUM which interfere with the presynaptic release of ACETYLCHOLINE at the NEUROMUSCULAR JUNCTION. Clinical features include abdominal pain, vomiting, acute PARALYSIS (including respiratory paralysis), blurred vision, and DIPLOPIA. Botulism may be classified into several subtypes (e.g., food-borne, infant, wound, and others). (From Adams et al., Principles of Neurology, 6th ed, p1208) Botulism, Infantile,Botulism, Toxico-Infectious,Clostridium botulinum Infection,Foodborne Botulism,Infant Botulism,Toxico-Infectious Botulism,Wound Botulism,Botulism, Foodborne,Botulism, Infant,Botulism, Toxico Infectious,Botulism, Wound,Clostridium botulinum Infections,Foodborne Botulisms,Infant Botulisms,Infantile Botulism,Infection, Clostridium botulinum,Toxico Infectious Botulism,Wound Botulisms
D003014 Clostridium botulinum A species of anaerobic, gram-positive, rod-shaped bacteria in the family Clostridiaceae that produces proteins with characteristic neurotoxicity. It is the etiologic agent of BOTULISM in humans, wild fowl, HORSES; and CATTLE. Seven subtypes (sometimes called antigenic types, or strains) exist, each producing a different botulinum toxin (BOTULINUM TOXINS). The organism and its spores are widely distributed in nature.
D006722 Honey A sweet viscous liquid food, produced in the honey sacs of various bees from nectar collected from flowers. The nectar is ripened into honey by inversion of its sucrose sugar into fructose and glucose. It is somewhat acidic and has mild antiseptic properties, being sometimes used in the treatment of burns and lacerations. Honeys
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000992 Antitoxins Antisera from immunized animals that is purified and used as a passive immunizing agent against specific BACTERIAL TOXINS. Antitoxin
D047014 Clostridium botulinum type B Subtype of CLOSTRIDIUM BOTULINUM that produces botulinum toxin type B which is neurotoxic to humans and animals.
D051379 Mice The common name for the genus Mus. Mice, House,Mus,Mus musculus,Mice, Laboratory,Mouse,Mouse, House,Mouse, Laboratory,Mouse, Swiss,Mus domesticus,Mus musculus domesticus,Swiss Mice,House Mice,House Mouse,Laboratory Mice,Laboratory Mouse,Mice, Swiss,Swiss Mouse,domesticus, Mus musculus

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