The First Case of Type A Botulism Associated with Eating Barbecued Caviar Fish

Botulism is a paralytic illness caused by the neurotoxin of clostridium botulinium. Food born botulism may develop after eating foods contaminated with botulinium toxin. Botulinium neurotoxin predominantly affects the peripheral neuromuscular junction and autonomic synapse, and its effects are primarily manifested as weakness. A 12-year-old boy presented with severe weakness, diplopia and dropping eyelids 6 hours following ingestion of barbecued caviar fish. Clinical presentations were constipation, dry mouth, diplopia, blurred vision, ptosis, dilated and reactive pupils, weakness and lethargy. Based on the clinical findings, the patient received three antitoxin A, B, E monovalent; and stool, gastric fluid as well as serum samples were sent for toxicological evaluation with standard mouse bioassay. Type A toxin was detected in stool sample of the patient. Ten days later, the patient was discharged in a good condition. This study confirmed that prompt administration of antitoxin can prevent progression of disease based on clinical judgment and may also be life saving.