en Infectious Diseases Infectious Diseases case report case report <p style="margin-left:4.5pt;"><span style="font-size:14px;"><span style="font-family:times new roman;"><span style="color:#0000FF;"><strong><em>Background:</em></strong></span> Botulism is an acute and rapidly progressive descending paralytic disease caused by a neurotoxin of clostridium botulinum.<br> <span style="color:#0000FF;"><strong><em>Case presentation:</em></strong></span> A 28-year-old woman presented with severe generalized ascending symmetrical muscle paralysis. The patient was intubated and transferred to the medical intensive care unit with several symptoms including: severe headache, dysphagia, dyspnea, ptosis, diplopia, and dry mouth. Despite being alert, pupils were bilaterally midriatic and had absent corneal reflux. Pansinusitis was seen in the paranasal sinus scan. At first, the movement of eyelids, head and neck were restored. The movement of the upper limbs (15^th day) and chest wall (20^th day), abdomen (25^th day) and the lower extremities (32^nd day) were then gradually restored. On 41st day, the patient was completely disconnected from the ventilator.<br> <span style="color:#0000FF;"><strong><em>Conclusions:</em> </strong></span>Botulism should be a diagnosis in any patient with an acute progressive symmetrical descending paralysis. Sinus mucosal injury (acute sinusitis) can be inoculated with spores of <em>botulinum</em></span></span></p> Acute sinusitis, Botulism, Paralysis 194 197 http://caspjim.com/browse.php?a_code=A-10-756-1&slc_lang=en&sid=1 Ali Tavassoli rohanresearch88@gmail.com 100319475328460012081 100319475328460012081 No Clinical Research Development Unit of Babol University of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Mahmood Sadeghi drm_sadeghihz@yahoo.com 100319475328460012082 100319475328460012082 No Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Parviz Amrimaleh pamrimaleh@gmail.com 100319475328460012083 100319475328460012083 Yes Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran