Journal Article

Intestinal Toxemia Botulism in Two Young People, Caused by <i>Clostridium butyricum</i> Type E

Lucia Fenicia, Giovanna Franciosa, Manoochehr Pourshaban and Paolo Aureli

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 6, pages 1381-1387
Published in print December 1999 | ISSN: 1058-4838
Published online December 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313497
Intestinal Toxemia Botulism in Two Young People, Caused by Clostridium butyricum Type E

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Two unconnected cases of type E botulism involving a 19-year-old woman and a 9-year-old child are described. The hospital courses of their illness were similar and included initial acute abdominal pain accompanied by progressive neurological impairment. Both patients were suspected of having appendicitis and underwent laparotomy, during which voluminous Meckel's diverticula were resected. Unusual neurotoxigenic Clostridium butyricum strains that produced botulinum-like toxin type E were isolated from the feces of the patients. These isolates were genotypically and phenotypically identical to other neurotoxigenic C. butyricum strains discovered in Italy in 1985–1986. No cytotoxic activity of the strains that might explain the associated gastrointestinal symptoms was demonstrated. The clinical picture of the illness and the persistence of neurotoxigenic clostridia in the feces of these patients suggested a colonization of the large intestine, with in vivo toxin production. The possibility that Meckel's diverticulum may predispose to intestinal toxemia botulism may warrant further investigation.

Journal Article.  4207 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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