Type F botulism due to neurotoxigenic Clostridium baratii from an unknown source in an adult

Abstract

Type F botulism was confirmed in a 54-year-old male with signs compatible with botulism who reported to the emergency unit of a hospital. Botulinal neurotoxin was detected in the patient's serum and fecal specimens, and a neurotoxigenic organism whose physiologic characteristics correspond to those of Clostridium baratii was isolated. The toxin produced by the isolate was neutralized by type F botulinal antitoxin and cross-neutralized with lower efficiency by type E antitoxin. The patient's food history was not suggestive of botulism, and it seems likely that the illness was due to colonization of the gut.

Genetic interrelationships of saccharolytic Clostridium botulinum types B, E and F and related clostridia as revealed by small-subunit rRNA gene sequences

“…Such gross distances could not be measured by earlier techniques such as chromosomal DNA-DNA pairing. Thirdly, BoNT-producing strains of C. barati and C. butyricum have now been described [6,18] which, by definition, are deemed to be C. botulinum. Genetically these organisms correspond to authentic C. barati and C. butyricum using the internationally recommended definition of the genospecies [19].…”

Global Distribution of Infectious Diseases Requiring Intensive Care

“…Relapses have been described. Clinically, and shortly after toxin ingestion, adult patients remain mentally intact but develop symmetric descending weakness acutely in the absence of fever or sensory deficit outside of the eyes [49]. Nausea, dry mouth, and diarrhea may accompany the neuropathy.…”

Sequence of the gene encoding type F neurotoxin of Clostridium botulinum

“…Outbreaks of botulism in humans and animals have resulted in the classification of the neurotoxin into seven serologically different forms identified as type A (BoNT/A) to type G (BoNT/G). BoNT/A, BoNT/B and BoNT/E are the main causative agents of human botulism, with rar, e incidents attributed to BoNT/F and BoNT/G [1]. The disease is most often the result of ingestion of toxin formed in foods that have been inadequately processed and/or stored at inappropriate temperatures.…”

“…Another source of the disease is after colonization of the gut by clostridia in infants of less than approx. 6 months, consequently known as infant botulism [1,2]. Occasionally botulism is the result of infection of a wound.…”

“…There have been reports of BoNT being produced by clostridia that phenotypicaily are not C botulinum viz. C butyticum and C barati [1,2]. Type F neurotoxin is produced by C. botulinum Group I (proteolytic strains), Group II (non-proteolytic strains) and by C. barati [3].…”