Botulism in the Brazilian Amazon: a life-threatening disease in a neglected population

Botulismo na Amazônia brasileira: uma doença fatal em uma população negligenciada

Abstract

Background

Botulism is a rare and potentially fatal neuroparalytic syndrome caused by the gram-positive anaerobe spore-forming bacteriumClostridium botulinum. The microorganism produces a neurotoxin that inhibits the presynaptic release of acetylcholine at the neuromuscular junction, clinically leading to a myasthenic syndrome.

Objective

To describe the recent outbreak of botulism cases and its demographic, clinical, and laboratory characteristics.

Methods

We report 4 patients with botulism in the recent outbreak occurred between 2017 and 2019 in the state of Amazon.

Results

Out of four patients with botulism, three contracted it from eating contaminated food and one had wound botulism. We emphasize the excellent clinical outcome of the different disease presentations in our case series.

Conclusion

The temporal proximity of these reports may suggest a new rise in the number of cases in the upcoming years. A possible hypothesis is that the rarity of the disease decreased the awareness regarding the primary prevention or even a diagnosis by an untrained physician.

Keywords
Botulism; Botulinum Toxins; Neglected Diseases