UMEM Educational Pearls

Category: Pediatrics

Title: Infantile botulism

Keywords: weakness, constipation (PubMed Search)

Posted: 8/20/2011 by Mimi Lu, MD
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Infantile botulism

- acute weakness in previously well infant < 6 months of age
- due to intestinal colonization by Clostridium botulinum, which produces neurotoxin
- spores found in soil, agricultural products and honey
initial constipation, followed by lethargy and feeding difficulties
hypoactive deep tendon reflexes, decreased suck and gag, poorly reactive pupils, bilateral ptosis, oculomotor palsies, and facial weakness.
C. botulinum toxin in feces or isolation in stool culture (less sensitive)
supportive, admission to observe for respiratory compromise (77% require eventual intubation), antitoxin has resulted in anaphylaxis in infants, no additional benefit with antibiotics (although often used)