Case history
Case history #1
The mother of a 4-month-old infant reports that he has had 3 to 4 days of constipation. She states that the baby has had difficulty feeding over the past 24 hours and is unable to suck and swallow. She is also worried that he feels limp in her arms and appears to have a very weak cry.
Case history #2
A 34-year-old man presents with the acute onset of blurry vision, nausea, and vomiting. He notes weakness in his arms and trunk. He recently returned from Alaska. Of note, he recalls eating home-preserved fish while visiting a family friend.
Other presentations
While botulinum toxin may reach the neuromuscular junction via several routes (foodborne, wound, iatrogenic, or inhalational), the clinical presentations of each are often indistinguishable.
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