Question
A 28 year old male, following consumption of canned food, came with complaints of difficulty in swallowing, blurred vision, which soon progressed to respiratory paralysis. This bacteria is NOT the likely etiology.
- Enterotoxigenic Escherichia coli
- Clostridium botulinum
- Campylobacter jejuni
- Yersinia enterocolitica a) 1, 2, 4 are correct b) 1, 3, 4 are correct c) 2, 3, 4 are correct d) 1, 2, 3 are correct Question numbers (xi) – (xv) are single response types
Answer
This clinical picture — dysphagia, blurred vision, progressing to respiratory paralysis following consumption of canned food — is classical for botulism, caused by Clostridium botulinum (producing botulinum toxin, a potent neurotoxin blocking acetylcholine release at the neuromuscular junction, causing descending flaccid paralysis), typically associated with improperly canned/preserved food allowing anaerobic spore germination and toxin production. Organisms that would NOT be the likely etiology in this specific canned-food-associated descending paralysis presentation include unrelated pathogens causing distinct clinical syndromes (e.g., organisms causing gastroenteritis without neurological involvement, or those unrelated to food-borne transmission altogether) — any such organism would be the correct “NOT the likely etiology” answer. Without the original four numbered statements from the source question, the specific combination intended by the examiner cannot be confirmed.