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Case Reports in Infectious Diseases
Volume 2012, Article ID 438989, 3 pages
http://dx.doi.org/10.1155/2012/438989
Case Report

The First Case(s) of Botulism in Vienna in 21 Years: A Case Report

1Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria
2Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria
3Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
4Clinical Institute of Hospital Hygiene, Medical University of Vienna, 1090 Vienna, Austria
5Austrian Agency for Health and Food Safety, Institute for Medical Microbiology and Hygiene, 1220 Vienna, Austria
6Austrian Agency for Health and Food Safety, Institute for Medical Microbiology and Hygiene, 8010 Graz, Austria
7Department of Ophtalmology and Optometry, Medical University of Vienna, 1090 Vienna, Austria
8Department of Neurology, Medical Universiy of Vienna, 1090 Vienna, Austria

Received 4 March 2012; Accepted 26 April 2012

Academic Editors: E. M. Stringer, S. Talhari, and G. Walder

Copyright © 2012 Matthias Gerhard Vossen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known. Methods: We review the available literature, the compiled clinical data, and observations. Results: After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases. Conclusion: Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production.