CC BY-NC-ND 4.0 · AJP Rep 2017; 07(03): e163-e166
DOI: 10.1055/s-0037-1604407
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Infant Botulism in the Very Young Neonate: A Case Series

Laura Jackson
1   Division of Newborn Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
,
Suneeta Madan-Khetarpal
2   Division of Medical Genetics, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
,
Monica Naik
3   Division of Neurology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
,
Marian G. Michaels
4   Division of Infectious Disease, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
,
Melissa Riley
1   Division of Newborn Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
› Author Affiliations
Further Information

Publication History

24 April 2017

14 June 2017

Publication Date:
31 July 2017 (online)

Abstract

Background Though botulism is a rare disease overall, all infants younger than 1 year of age are at risk of contracting infant botulism, the most prevalent form reported in the United States. Nonetheless, infant botulism is frequently omitted from the differential diagnosis of the very young neonate exclusively due to age, and the diagnosis is often only considered secondarily after a costly and prolonged work up is undertaken. Delayed diagnosis can lead not only to unnecessary testing but also to prolonged hospital stay and increased morbidity.

Case This case series highlights three critically ill neonates, all younger than 30 days, who presented to our neonatal intensive care unit and were eventually diagnosed with infant botulism. The initial diagnostic dilemma is described for each of these patients and highlights the importance of early recognition of the main symptoms, in addition to consideration of important potential coinciding conditions.

 
  • References

  • 1 Carrillo-Marquez MA. Botulism. Pediatr Rev 2016; 37 (05) 183-192
  • 2 Arnon S. Infant botulism. In: Cherry JD. , ed. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2013: 1801-1809
  • 3 Arnon S, Barzilay E. Clostridial infections: botulism and infant botulism (Clostridium botulinum). In: Kimberlin D. , ed. Red Book. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015: 294-296
  • 4 Thilo EH, Townsend SF, Deacon J. Infant botulism at 1 week of age: report of two cases. Pediatrics 1993; 92 (01) 151-153
  • 5 Keet CA, Fox CK, Margeta M. , et al. Infant botulism, type F, presenting at 54 hours of life. Pediatr Neurol 2005; 32 (03) 193-196
  • 6 Burr DH, Sugiyama H. Susceptibility to enteric botulinum colonization of antibiotic-treated adult mice. Infect Immun 1982; 36 (01) 103-106
  • 7 Fox CK, Keet CA, Strober JB. Recent advances in infant botulism. Pediatr Neurol 2005; 32 (03) 149-154
  • 8 Rosow LK, Strober JB. Infant botulism: review and clinical update. Pediatr Neurol 2015; 52 (05) 487-492
  • 9 Francisco AM, Arnon SS. Clinical mimics of infant botulism. Pediatrics 2007; 119 (04) 826-828
  • 10 Gutierrez AR, Bodensteiner J, Gutmann L. Electrodiagnosis of infantile botulism. J Child Neurol 1994; 9 (04) 362-365
  • 11 Arnon SS, Schechter R, Maslanka SE, Jewell NP, Hatheway CL. Human botulism immune globulin for the treatment of infant botulism. N Engl J Med 2006; 354 (05) 462-471