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Detrusor Underactivity Model in Rats by Conus Medullaris Transection

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Persistent neurogenic bladder dysfunction due to infantile botulism.

Anders Breinbjerg¹, Søren Rittig, Konstantinos Kamperis

¹Department of Pediatrics, Aarhus University Hospital, Aarhus N, Denmark.

BMJ Case Reports

|January 15, 2014

Summary

Infantile botulism in a 5-month-old infant caused neurogenic bladder dysfunction. While the infant recovered, bladder issues persisted, requiring interventions and follow-up urodynamic evaluations.

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Area of Science:

Pediatric Neurology
Urology

Background:

Infantile botulism is a rare neuromuscular disorder caused by Clostridium botulinum toxin.
Neurogenic bladder dysfunction can manifest as a complication in various pediatric conditions.

Observation:

A 5-month-old infant diagnosed with infantile botulism presented with progressive muscle weakness, hypotonia, and absent reflexes.
The infant developed urinary retention requiring bladder drainage and later intermittent catheterization.
Persistent bladder underactivity was noted even after initial recovery from botulism.

Findings:

Botulinum neurotoxin type A was confirmed in the infant's serum.
Urodynamic evaluations over 1.5 years showed evolving detrusor activity and bladder emptying.
The infant experienced a urinary tract infection and recurrent bladder emptying issues.

Implications:

This case highlights the potential for infantile botulism to cause prolonged neurogenic bladder dysfunction.
Early diagnosis and urodynamic monitoring are crucial for managing bladder complications in affected infants.
Complete resolution of bladder dysfunction may require extended follow-up and interventions.