How Not to Miss Botulism? Clinical Case, Error Analysis, And Recommendations for Practitioners
https://doi.org/10.20514/2226-6704-2025-15-6-452-460
EDN: FBHHZS
Abstract
Botulism is still an urgent medical problem, leading to fatal outcomes. The article presents a typical clinical case of severe botulinum toxin poisoning, characterized by the maximum severity of all symptoms of the disease with signs of decompensated acute respiratory failure, dysphagia, ophthalmoplegic and bulbar syndromes. The difficulties and errors of clinical diagnosis that have arisen due to the similarity of botulism with other pathologies are analyzed.
About the Authors
M. O. Berezin
Northern State Medical University
Russian Federation
Competing Interests:
Russian Federation
Matvej O. Berezin — postgraduate student of the Department of Infectious Diseases
Arkhangelsk
Competing Interests:
The authors declare no conflict of interests
O. V. Samodova
Northern State Medical University
Russian Federation
Competing Interests:
Russian Federation
Olga V. Samodova — Dr. Sci. (Med.), Professor, Head of the Department of Infectious Diseases
Arkhangelsk
Competing Interests:
The authors declare no conflict of interests
G. B. Shekhurin
Northern State Medical University
Russian Federation
Competing Interests:
Russian Federation
Gleb B. Shekhurin — postgraduate student of the Department of Infectious Diseases
Arkhangelsk
Competing Interests:
The authors declare no conflict of interests
K. V. Butorina
Arkhangelsk Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Kristina V. Butorina — infectious disease doctor, Head of the Emergency Department of the Infectious Disease Center
Arkhangelsk
Competing Interests:
The authors declare no conflict of interests
A. V. Bogdanova
Arkhangelsk Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Aleksandra V. Bogdanova — Cand. Sci. (Med.), Deputy Chief Physician for Clinical and Expert Work
Arkhangelsk
Competing Interests:
The authors declare no conflict of interests
I. V. Shchepina
Arkhangelsk Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Irina V. Shchepina — Cand. Sci. (Med.), Head of the Infectious Disease Center
Arkhangelsk
Competing Interests:
The authors declare no conflict of interests
References
1. The St.-Petersburg And Leningrad Region Infectious Diseases Physicians Association, International Public Organization “Euro-Asian Society for Infectious Diseases”. Botulism in children. Federal Clinical Guidelines of the Ministry of Health of the Russian Federation. Moscow, 2024. [Electronic resource]. URL: https://cr.minzdrav.gov.ru/view-cr/697_2. (date of the application: 08.02.2025) [In Russian]
2. Jeffery IA, Nguyen AD, Karim S. Botulism. 2024 Nov 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29083673
3. Rawson AM, Dempster AW, Humphreys CM, et al. Pathogenicity and virulence of Clostridium botulinum. Virulence. 2023 Dec;14(1):2205251. doi: 10.1080/21505594.2023.2205251. PMID: 37157163; PMCID: PMC10171130
4. WHO: Botulism. Fact sheets. [Electronic resource]. URL: https://www.who.int/news-room/fact-sheets/detail/botulism. (date of the application: 08.02.2025)
5. Yushchuk N.D., Vengerov Yu.Ya. (eds). Infectious diseases. National guidelines. 3rd ed., revised and additional. Moscow: GEOTAR-Media, 2021: 1104 p. (National Guidelines Series). DOI: 10.33029/97046122-8-INB-2021-1-1104 ISBN 978-5-9704-6122-8 [In Russian]
6. Martynova P.V., Grosheva M. Popova named the cause of the outbreak of botulism in Russia. RBC. 2024. 11 Jul. [Electronic resource]. URL: https://www.rbc.ru/society/11/07/2024/668f846b9a794744d077b492. (date of the application: 08.02.2025) [In Russian]
7. Antonov M.M., Rogoza A.V. The raw materials were stored in the heat, the expiration date was taken “off the wall”: Under what conditions were beans “with botulism” made, which poisoned more than 300 people. Komsomolskaya Pravda. 2024. 20 Jun. [Electronic resource]. URL: https://www.kp.ru/daily/27597/4948413. (date of the application: 12.03.2025) [In Russian]
8. Zakharova L. Botulism: experience of the Russian outbreak. Meditsinskii vestnik. 2024. 13 oct. [Electronic resource]. URL: https://medvestnik.by/news/botulizm-iz-opyta-rossijskoj-vspyshki. (date of the application: 25.03.2025) [In Russian]
9. Lonati D, Schicchi A, Crevani M, et al. Foodborne Botulism: Clinical Diagnosis and Medical Treatment. Toxins (Basel). 2020 Aug 7;12(8):509. doi: 10.3390/toxins12080509. PMID: 32784744; PMCID: PMC7472133
10. Sergeeva I.V., Rakhimi Sh.Kh. Diagnostic errors in botulism. Russian Medical Inquiry. 2022;6(11):667–670. DOI: 10.32364/2587-6821-2022-6-11-667-670 [In Russian]
11. Nikiforov VV, Kozhevnikova AV, Tyurin IN, et al. Underdiagnosis of botulism as a cause of tragedy: A casereport. Epidemiology and Infectious Diseases. 2024;29(3):204–214. DOI: 10.17816/EID632547 [In Russian]
12. Taюkэn Ц, Akpэnar AA. The enemy at the gate: Botulism. Turk J Emerg Med. 2024 Jul 1;24(3):127-132. doi: 10.4103/tjem.tjem_80_24. PMID: 39108685; PMCID: PMC11299839
13. Centurioni DA, Egan CT, Perry MJ. Current Developments in Diagnostic Assays for Laboratory Confirmation and Investigation of Botulism. J Clin Microbiol. 2022 Apr 20;60(4): e0013920. DOI: 10.1128/JCM.00139-20. Epub 2021 Sep 29. PMID: 34586891; PMCID: PMC9020338
14. Kharchenko G.A., Kimirilova O.G., Kimirilov A.A. Difficulties of differential diagnosis of botulism. Lechaschi Vrach Journal. 2020;1:47-51. DOI: 10.26295/OS.2019.70.74.010 [In Russian]
15. Association of Neurosurgeons of Russia, Russian Society of Neurologists, National Association for the Fight Against Stroke, All-Russian public organization “Union of Rehabilitologists of Russia”, Interregional Public organization “Association of Neuroanesthesiologists and neuroresuscitators”. Ischemic stroke and transient ischemic attack. Federal Clinical Guidelines of the Ministry of Health of the Russian Federation. Moscow, 2024. [Electronic resource]. URL: https://cr.minzdrav.gov.ru/view-cr/814_1. (date of application: 08.02.2025) [In Russian]
16. Association of Neurosurgeons of Russia, Russian Society of Neurologists, All-Russia Public Organization «Federation of Anaesthesiologists and Reanimatologists». Hemorrhagic stroke. Federal Clinical Guidelines of the Ministry of Health of the Russian Federation. Moscow, 2022. [Electronic resource]. https://cr.minzdrav.gov.ru/viewcr/523_2. (date of application: 08.02.2025) [In Russian]
17. National Association of Infectious Diseases Specialists named after Academician V.I. Pokrovsky. Botulism in adults. Federal Clinical Guidelines of the Ministry of Health of the Russian Federation. Moscow, 2025. [Electronic resource]. URL: https://cr.minzdrav.gov.ru/view-cr/911_1. (date of application: 09.06.2025) [In Russian]
18. National Association of Infectious Diseases Specialists named after Academician V.I. Pokrovsky. Acute intestinal infections (AII) in adults. Federal Clinical Guidelines of the Ministry of Health of the Russian Federation. Moscow, 2024. [Electronic resource]. URL: https://cr.minzdrav.gov.ru/view-cr/875_1. (date of application: 08.02.2025) [In Russian]
19. Rao AK, Sobel J, Chatham-Stephens K, et al. Clinical Guidelines for Diagnosis and Treatment of Botulism, 20 21. MMWR Recomm Rep. 2021 May 7;70(2):1-30. DOI: 10.15585/mmwr.rr7002a1. PMID: 33956777; PMCID: PMC8112830
Review
For citations:
Berezin M.O., Samodova O.V., Shekhurin G.B., Butorina K.V., Bogdanova A.V., Shchepina I.V. How Not to Miss Botulism? Clinical Case, Error Analysis, And Recommendations for Practitioners. The Russian Archives of Internal Medicine. 2025;15(6):452-460. (In Russ.) https://doi.org/10.20514/2226-6704-2025-15-6-452-460. EDN: FBHHZS
Views:
209
JATS XML
Email this article 