We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases\r\nmay present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known.\r\nMethods:We review the available literature, the compiled clinical data, and observations. Results: After a slow onset of clinical signs\r\na married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool\r\nretention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in\r\nAustria. In the last 21 years there were only twelve reported cases. Conclusion: Both patients went to a general practitioner as well\r\nas several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between\r\nintoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin\r\ncan produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of\r\nindustrial food production.
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