A 33-year-old patient came into the emergency room with complaints of blurred vision and slurred speech. He was under psychiatric treatment for depression and a diagnosis of reactive depression was made. Signs of muscle weakness became progressive. The patient revealed that he had eaten pickled eggs 24 hours prior to admission. Arterial blood gases showed respiratory acidemia and the patient was intubated and mechanically ventilated. Food botulism was the confirmed diagnosis based on analysis of gastric contents. The patient's respiratory status stabilized while he was receiving aerosol and postural drainage treatments. Twenty-three days after admission there were signs of muscle strength and recovery was gradual. Complications included recurrent pneumonia and urinary tract infection. Treatment for food botulism includes gastric lavage, purgatives, antibiotics, respiratory support, aggressive physical therapy, and meticulous nursing care. Although mortality was 65%, it is now 12.6%, with the increase in survival attributed to improved supportive care and ventilatory assistance.
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