OCR Text |
Show Canned Own Beets: Case Of Botulism A 22-vear-old woman was transferred to the University of Utah Medical Center from a hospital in Montana with presumed myasthenia gravis. SYMPTOMS and signs included blurred vision, diplopia, dysphagia, slurred speech, dry mouth, facial and neck weakness, and. over the next few days, descending, proximal muscle weakness. The spinal fluid was normal but the Tensilon R test was equivocal. She gave a history of consuming con-suming home-canned beets (her first try at canning!) 3 days before onset of neurologic symptoms; she experienced diarrhea 8 hours after consumption. AN elect romyogram showed the response of facilitation facili-tation with repetitive stimuli-a characteristic of both botulism and Eaton-Lambert Eaton-Lambert syndrome but not myasthenia gravis. She was treated as a presumed case of botulism and given tnvalent (A.B, and E) antitoxin. She never required respiratory respira-tory assistance and her recovery is near completed. Serum and stool samples were negative for toxin but Type A toxin and C botulinum Type A were recovered from a sample of the beets. THIS CASE, the third seen in Utah in 1975. represents a . moderate intoxication. Botulism Bo-tulism can present with only symptoms and signs of autonomic au-tonomic dysfunction (blurred vision, dry mouth, dizziness, constipation, urinary retention, reten-tion, diarrhea). The Tensilon R test has been equivocal and even "positive" in some cases of conlirmed botulism. It is important im-portant to use a normal saline control for comparison. E.M.G. can be very helpful in making the diagnosis early. . |