More detail has been shared about the diagnosis of a patient who fell seriously ill after having almond milk in Australia. A 61‐year‐old man suffered severe botulism symptoms in 2023 after drinking a dairy alternative. According to an article in The Medical Journal of Australia, it was the first botulism case in the country linked to a commercially prepared product since 2007.
As no suspected food poisoning was initially disclosed, brainstem stroke was the primary differential diagnosis. On day 2, the patient developed vomiting, difficulty swallowing, and severe respiratory distress, requiring intubation. He subsequently had complete ophthalmoplegia (weakness or paralysis of eye muscles ) , descending flaccid paralysis, and required ventilation.
A diagnosis of Miller-Fisher syndrome was then considered. Link to almond milk Further history on day 15 revealed the man had consumed foul‐tasting almond milk 12 to 36 hours before symptom onset. Botulism was then suspected.
Clostridium botulinum culture and test results were negative on a retained milk sample and stool. Results from the Clostridium botulinum direct toxin test using the mouse bioassay showed the presence of botulinum toxin in a retained milk sample. Another test on a retained milk sample detected botulinum toxin A nucleic acid.
On day 16, the patient was given botulin antitoxin. He was weaned off mechanical ventilation five months after admission to the intensive care unit. Following notification of the suspect.