Infant botulism is caused by the ingestion of Clostridium botulinum spores and leads to a life-threatening descending motor weakness and flaccid paralysis in infant children. This disease presents with symptoms such as constipation, weakness, and hypotonia and can lead to respiratory failure. Botulism immune globulin (BIG) was created to treat this deadly disease and functions by neutralizing all systemically circulating botulism toxins. It is indicated in children with clinically diagnosed infant botulism, before diagnostic confirmation, and has been shown to lead to a significant reduction in intensive care unit and hospital stay for these patients. This review article discusses the epidemiology, clinical presentation, history of BIG, and indications for administration of BIG.

Mucocele of the appendix is an exceedingly uncommon pathology in the pediatric population that may present with abdominal pain or represent an incidental finding after routine abdominal imaging. Etiologies may be inflammatory or neoplastic, but all share the commonality of chronic appendiceal obstruction. Early diagnosis is critical for positive long-term outcomes because the operative management will differ from that of a dilated appendix secondary to acute appendicitis.

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Our AHC model showed a significant reduction in length of stay and charges in compared demographically and clinically matched PED patients. This may be an effective model to help address emergency department overcrowding and promote patient safety.

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