Introduction:
Botulism is a rare but potentially life-threatening neuroparalytic syndrome resulting from the action of a neurotoxin elaborated by Clostridium botulinum. The only definite food source known to cause infantile botulism is honey.
Ninety percent of cases occur in infants
Case Report:
A 8-month-old boy presented to our ED after referral from his pediatrician due to decreased feeding, constipation and apathy for the past 3 days. Without history of vomiting or diarrhea.
according to his mother ,His grandmother gave him two teaspoon of honey everyday.
On examination: his vital signs were within normal limits, well nourished and well developed child, but he seems lethargic, with generalized weakness . The workup included: CBC, complete metabolic panel , chest x-ray, head CT and lumbar puncture was normal.
Diagnosis was confirmed with positive botulinum toxin in the stool samples. Treatment included botulism immunoglobulin, full recovery was made by the infant.
Conclusion:
Diagnosis of infantile botulism requires a high degree of clinical suspicion, as symptoms at presentation is typically very vague. However, if a young infant presents with the common symptoms of constipation, poor or decreased feeding, and weakness the diagnosis of infantile botulism should be considered. Botulism immunoglobulin should be administered even before a laboratory confirmation is present. The single most effective way to prevent infant botulism is for infants to avoid honey.
