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

Authors

  • Lucas José Sá da Fonseca Universidade Federal de Alagoas, Hospital Universitário Professor Alberto Antunes, Unidade de Reumatologia https://orcid.org/0000-0002-8850-841X
  • Diogo Couto de Carvalho Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Medicina Interna
  • Helena Providelli de Moraes Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Neurologia
  • Izabela Dayany França Feitosa Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Neurologia
  • Gil Pereira Neto Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Neurologia
  • Rodrigo Vasconcellos Vilela Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Neurologia
  • Breno Franco Silveira Fernandes Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Neurologia
  • Rodrigo Santiago Gomez Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Neurologia
  • Vandack Nobre Universidade Federal de Minas Gerais, Hospital das Clínicas, Departamento de Medicina Interna, Unidade de Terapia Intensiva

DOI:

https://doi.org/10.1590/s1678-9946201961049

Keywords:

Adult intestinal toxemia botulism, Neuropathy, Intestinal colonization, Diagnosis, Neuromuscular junction, Symmetrical descending flaccid paralysis, Clostridium botulinum

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.

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Published

2019-09-13

Issue

Section

Case Report

How to Cite

Fonseca, L. J. S. da, Carvalho, D. C. de, Moraes, H. P. de, Feitosa, I. D. F., Pereira Neto, G., Vilela, R. V., Fernandes, B. F. S., Gomez, R. S., & Nobre, V. (2019). Hospital-acquired intestinal toxemia botulism in a newly diagnosed adult colon cancer patient. Revista Do Instituto De Medicina Tropical De São Paulo, 61, e49. https://doi.org/10.1590/s1678-9946201961049