An 18-year-old male presented with acute onset descending paralysis after 3 days of intake of canned food. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are nonreactive. The most probable diagnosis is: (A) Tetanus, (B) Botulism, (C) Poliomyelitis, (D) Gullian Baree syndrome
Answer is B. The above clinical scenario is suggestive of botulism. Points in or of botulism: History of intake of canned food, descending paralysis, history of blurred vision, quadriparesis (flaccid paralysis), areflexia, and non-reactive pupils. Tetanus causes spastic paralysis. Guillain-Barre syndrome usually associated with ascending flaccid paralysis. Polio-Weakness is generally asymmetric, is proximal more than distal, and may involve the legs (most commonly); the arms;or the abdominal, thoracic, or bulbar muscles. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition