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The first case of type B infant botulism in Japan
H Kakinuma1, H Maruyama, H Takahashi
1Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan.
Insights
Infant botulism, caused by Clostridium botulinum type B, presented with severe weakness and cranial nerve dysfunction in a Japanese infant. This case highlights the importance of considering infant botulism even without a history of honey consumption.
Area of Science:
- Pediatrics
- Infectious Diseases
- Toxicology
Background:
- Infant botulism is a rare but serious neuroparalytic illness caused by the toxin produced by Clostridium botulinum bacteria.
- While often associated with honey consumption in infants under one year old, alternative sources of exposure are possible.
- Early diagnosis and management are crucial to prevent severe complications.
Observation:
- A six-month-old infant presented with progressive generalized weakness, poor feeding, constipation, and cranial nerve palsies.
- The clinical presentation suggested a possible diagnosis of infant botulism despite the absence of a known history of honey ingestion.
- Diagnostic investigations were initiated to confirm the etiology.
Findings:
- Mouse bioassay of enema effluent confirmed the presence of type B botulinum toxin.
- Culture of the effluent yielded positive results for Clostridium botulinum type B.
- This marked the first documented case of type B infant botulism in Japan.
Implications:
- This case underscores the need for heightened clinical suspicion for infant botulism in infants presenting with characteristic neurological symptoms, irrespective of reported honey exposure.
- The identification of type B toxin in this Japanese infant expands the known geographical and etiological spectrum of infant botulism.
- Further surveillance and research are warranted to understand the prevalence and transmission routes of Clostridium botulinum in Japan.
Abstract:
A six-month-old girl with a 5 consecutive day history of constipation and poor feeding developed generalized weakness, poor head control, difficulties in sucking and swallowing, and cranial nerve dysfunction within a few days. These characteristic manifestations and clinical course prompted examination of the possibility of infant botulism, although no history of eating honey was obtained. Mouse bioassay performed with enema effluent demonstrated type B botulinum toxin. Culture of the effluent was positive for Clostridium botulinum type B. This is the first case of type B infant botulism in Japan.