Emergency Care Journal (Apr 2024)

A rare symptom of foodborne botulism: dysgeusia. Case report and clinical review

  • Simone Esposito,
  • Francesco Coletta,
  • Giovanna Di Maiolo,
  • Filomena Lo Chiatto,
  • Pasquale Rinaldi,
  • Anna Lanza,
  • Getano Panico,
  • Crescenzo Sala,
  • Antonio Tomasello,
  • Romolo Villani

DOI
https://doi.org/10.4081/ecj.2024.12322

Abstract

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Clostridium botulinum has become one of the most well-known microorganisms in medical history, thanks to both fatal botulism epidemics and the recent medical use of botulinum neurotoxin. It is a Gram-positive, anaerobic, spore-forming bacterium that causes classic foodborne botulism, infant botulism, wound botulism, and intestinal colonization botulism, a serious neuroparalytic disease. The most common type of botulism is foodborne botulism, which is caused by eating botulinum toxin-contaminated foods. Just a few micrograms of toxin are enough to cause symptoms and, if untreated, death. Rapid diagnosis of the condition is critical to avoiding fatal outcomes. This article describes a clinical case of a patient who presented to us in June with typical symptoms of botulism. Early clinical diagnosis is based on a thorough medical history, including a meticulous reconstruction of the patient's food history in the days preceding symptom onset, as well as a careful physical examination, which can be highly suggestive of botulinum intoxication. Botulism treatment consists of symptom control, mechanical respiratory support, and Botulinum Antitoxin (BAT) administered intravenously. Epidemiological investigation is critical for quickly identifying the food vehicle causing the intoxication.

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