Hospital-acquired intestinal toxemia botulism in a newly diagnosed adult colon cancer patient

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Lucas José Sá da Fonseca, Diogo Couto de Carvalho, Helena Providelli de Moraes, Izabela Dayany França Feitosa, Gil Pereira Neto, Rodrigo Vasconcellos Vilela, Breno Franco Silveira Fernandes, Rodrigo Santiago Gomez, Vandack Nobre
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP)
• Subjects: Adult intestinal toxemia botulism; Neuropathy; Intestinal colonization; Diagnosis; Neuromuscular junction; Symmetrical descending flaccid paralysis; Clostridium botulinum; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946201961049; https://doaj.org/article/18279b98d2ee4b508ab8bbb363547df7

ABSTRACT This manuscript reports a case of intestinal toxemia botulism in an adult with recently diagnosed metastatic colon cancer in whom botulism symptoms began 23 days after hospital admission. Representing the rarest form of botulism presentation in clinical practice, this infectious disease may have developed due to a cluster of predisposing factors that favored Clostridium botulinum colonization and the endogenous production of neurotoxins, among which are previous use of broad-spectrum antibiotics and colon changes related to the development of the neoplasia. This case highlights the importance of considering intestinal toxemia botulism in the differential diagnosis of a patient presenting with symmetrical descending flaccid paralysis, since immediate treatment with botulinum antitoxin may improve clinical outcomes.