2025 Volume 32 Article ID: 32_R43
Foodborne botulism has rarely been reported in the past decade. Here, we report two cases, each presenting with unique complications. Case 1 involved a 41-year-old woman who presented with symptoms of diplopia, dysarthria, and muscle weakness. After a thorough review of her medical history, botulism was suspected. Despite receiving antitoxin therapy, her muscle strength did not improve, necessitating a tracheostomy on the fourth day of hospitalization. On the sixth day, she developed non-occlusive mesenteric ischemia (NOMI), which required surgical intervention. Postoperatively, her recovery progressed well, and she was discharged from the ICU on the 17th day. Case 2 involved a 48-year-old man, who was the spouse of Case 1, and presented with symptoms of diplopia and dysarthria, raising clinical suspicion of botulism. Despite receiving antitoxin therapy, the patient required mechanical ventilation. On the fourth day of hospitalization, he developed ventilator-associated pneumonia (VAP). A tracheostomy was performed on the 12th day, and by the 20th day, mechanical ventilation was no longer necessary. Although NOMI is a rare complication of botulism treatment, its high mortality rate-rather than its rarity-poses a threat to survival. Nevertheless, the patient survived. The diagnosis of botulism is challenging due to its symptom overlap with other neuromuscular disorders. In Case 1, the patient’s medical history, as provided by her family, enabled prompt diagnosis and facilitated the initiation of appropriate treatment.
