title: Early diagnosis and treatment in a child with foodborne botulism.
abstract: BACKGROUND
  Foodborne botulism is a neuroparalytic disease caused by ingestion of food contaminated with botulinum toxins. Despite rare the mortality rate is high if untreated. Diagnosis of botulism is still a challenge for clinician, due to the variability of clinical manifestations and disease course. We report on a child with type B botulin intoxication who was early diagnosed and treated underlining that clinical suspicion is crucial to start prompt treatment.
  
  
  METHODS
  An 11-year-old boy presented with bilateral ptosis and mydriasis, dry mouth, difficulty in swallowing, dysphonia, urine retention and constipation. Clear sensorium and no fever were observed. Immediately the suspicion of botulism was risen and botulinum antitoxin was administered. 3 days later serum and rectal samples tested positive for Clostridium botulinum. The patient completely recovered when discharged from hospital.
  
  
  CONCLUSIONS
  Foodborne botulism is still possible in developed countries. The confirmation test of botulism requires some days. To avoid long delays between intoxication and diagnosis prompt clinical suspicion is thus crucial. The outcome depends on rapid implementation of appropriate management with intensive respiratory care and antitoxin administration.
authors.affiliation: Department of Pediatrics, AORN "Santobono-Pausilipon", Naples, Italy. Electronic address: ziaree@alice.it.
authors.forename: Maria Renata
authors.initials: MR
authors.lastname: Proverbio
authors.affiliation: Department of Pediatrics, AORN "Santobono-Pausilipon", Naples, Italy. Electronic address: marta.lamba@libero.it.
authors.forename: Marta
authors.initials: M
authors.lastname: Lamba
authors.affiliation: Department of Translational Medical Sciences, Section of Pediatrics, "Federico II" University, Naples, Italy. Electronic address: ale.ro_ar@libero.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Department of Pediatrics, AORN "Santobono-Pausilipon", Naples, Italy. Electronic address: pediatria.santobono@gmail.com.
authors.forename: Paolo
authors.initials: P
authors.lastname: Siani
mesh_terms: D000818:Animals; D001904:Botulinum Antitoxin / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000097:blood; D001906:Botulism / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002417:Cattle; D002648:Child; D003014:Clostridium botulinum / Q000302:isolation & purification / Q000472:pathogenicity*; D042241:Early Diagnosis; D005517:Foodborne Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008460:Meat / Q000382:microbiology*
chemical_list: D001904:Botulinum Antitoxin; C096323:rimabotulinumtoxinB; D019274:Botulinum Toxins, Type A
keywords: Antitoxin; Botulism; Clinical suspicion; Intensive respiratory care