An 18-year-old male presented with acute onset descending paralysis after 3 days of intake of canned food. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are nonreactive. The most probable diagnosis is

The above clinical scenario is suggestive of botulism. Points in or of botulism: History of intake of canned food, descending paralysis, history of blurred vision, quadriparesis (flaccid paralysis), areflexia, and non-reactive pupils. Tetanus causes spastic paralysis. Guillain-Barre syndrome usually associated with ascending flaccid paralysis. Polio-Weakness is generally asymmetric, is proximal more than distal, and may involve the legs (most commonly); the arms;or the abdominal, thoracic, or bulbar muscles. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition