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[Three infants with constipation and muscular weakness: infantile botulism]
Y Thomasse1, J P Arends, P A van der Heide
1Universitair Medisch Centrum Groningen, 9700 RB Groningen.
Insights
Infantile botulism, caused by Clostridium botulinum toxin, can present with apathy and weakness in infants. Honey consumption is a risk factor, and infants under 12 months should avoid it.
Area of Science:
- Pediatrics
- Infectious Diseases
- Toxicology
Background:
- Infantile botulism is a rare but serious condition.
- Early diagnosis and intervention are crucial for infant outcomes.
Observation:
- Three previously healthy infants presented with apathy, muscle weakness, and constipation.
- One infant developed respiratory insufficiency, requiring hospitalization.
Findings:
- Clostridium botulinum toxin was detected in the serum of all three infants.
- Type-B toxin was identified in two infants who recovered; Type-A toxin was found in the infant who died.
- Honey consumption was noted in two of the affected infants.
Implications:
- Infantile botulism should be suspected in infants with hypotonia and constipation.
- Electromyography with repetitive stimulation can aid rapid diagnosis.
- Honey is a known source of Clostridium botulinum spores and should be avoided in infants under 12 months.
Abstract:
Two previously healthy infants, a boy of 10 weeks and a girl of 4 months presented with apathy and muscle weakness. A third previously healthy child, a girl of 6 weeks old was admitted with respiratory insufficiency. None of the three had had a bowel movement for a number of days. After extensive investigations which revealed few abnormalities Clostridium botulinum toxin was obtained in serum from all three children. Type-B-toxin was shown in the faeces of the older girl and boy; both recovered quickly. The other girl had type-A toxin; she died. Two of the three children were given honey to comfort them. Infantile botulism must be considered in every infant with symptoms of constipation and hypotonia. The diagnosis can quickly be confirmed by electromyography with repetitive 50-Hz-stimulation. Honey is a well-known source of the C. botulinum spore and should not be given to children under the age of 12 months. These three children are the first cases to be described in the Netherlands.
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