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May 1975

Guanidine in Type B Botulism: Shin J. Oh, MD; James H. Halsey, Jr., MD;

Author Affiliations

From the Department of Neurology and Medicine, University of Alabama School of Medicine, and Veterans Administration Hospital, Birmingham, Ala.

Arch Intern Med. 1975;135(5):726-728. doi:10.1001/archinte.1975.00330050100017

In the recent years, guanidine hydrochloride treatment has been reported to cause clinical improvement in cases with type A botulism. In type B, guanidine therapy has been tried only in two previous cases. We are reporting here successful guanidine therapy in one case with type B botulism.

PATIENT SUMMARY  A 54-year-old man ate home-preserved tomatoes on Feb 6, 1974. Five hours later, he began to vomit, and on the following day, he developed dysarthria, diplopia, and dysphagia, which were soon followed by shortness of breath and difficulty in walking. Because of progression of these symptoms, he was admitted on Feb 9 to the intensive care unit. On Feb 11, he was transferred to the University Hospital because of progressive respiratory distress. By the time of transfer, he also had urinary retention.The patient was alert but mute because of bulbar paralysis. His blood pressure was 105/70 mm Hg. Respirations were

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