Luna-Mazzillo A, Mazzillo-Vega L

Language: Spanish
References: 23
Page: 166-170
PDF size: 768.51 Kb.

ABSTRACT

Introduction: wound botulism is a rare neuroparalytic disease in pediatrics caused by botulinum toxin. Early recognition poses a diagnostic challenge. Objective: to describe the case of a pediatric patient with wound botulism and highlight the diagnostic and therapeutic difficulties in a setting with limited access to confirmatory tests and botulinum antitoxin. Case presentation: a 12-year-old male with an open, contaminated fracture of the left tibia and fibula. The clinical presentation was characterized by dysphagia, dysarthria, and progression to symmetrical descending flaccid paralysis, accompanied by cranial nerve involvement, mydriasis, and respiratory failure, yet with preserved consciousness. Mechanical ventilation was required. Botulism was suspected retrospectively based on the clinical course following the fracture. The patient showed slow but progressive neurological recovery with intensive support and physical rehabilitation. Conclusions: wound botulism should be considered in patients with contaminated wounds and progressive acute flaccid paralysis.

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