Early severe infantile botulism

Hurst, Daniel J.; Marsh, W. W.

doi:10.1016/s0022-3476(09)90016-6

Cited by 21 publications

(12 citation statements)

References 7 publications

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“…These babies appear 'floppy,' and may manifest various neurologic signs such as ptosis, ophthalmoplegia, sluggish reaction of the pupils, dysphagia, weak gag reflex and poor anal sphincter tone. 31,32 In seriously ill babies, respiratory arrest may occur.…”

Section: Clinical Manifestationmentioning

confidence: 99%

“…A few cases have shown slight elevation in the cerebrospinal fluid protein because of dehydration. 32 The only procedure that consistently corroborated the clinical diagnosis of IB was electromyography (EMG). The EMG shows a characteristic pattern of (1) brief, small-amplitude, abundant, motor-unit action potential (BSAP), 36 (2) enhancement of compound action potential in response to rapid repetitive nerve stimulation, (3) normal nerve conduction velocity and (4) no response to edrophonium chloride or neostigmine injection.…”

Section: Diagnosismentioning

confidence: 99%

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Infant botulism

Brook

2007

J Perinatol

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Infant botulism results from the absorption of heat-labile neurotoxin produced in situ by ingested Clostridium botulinum. Honey and environmental exposure are the main sources of acquisition of the organism. Clinical manifestations are owing to progressive neuromuscular blockade, initially of muscles innervated by cranial nerves and later of the trunk, extremities and diaphragm. Presynaptic autonomic nerves are also affected. The diagnosis is made on clinical grounds and is confirmed by recovery of the organism or by detection of toxin in the stool. Management includes meticulous supportive intensive care that may include mechanical ventilation and administration of human botulinum immunoglobulin in severe cases.

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Section: Clinical Manifestationmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Infant botulism

Brook

2007

J Perinatol

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“…15 Two infants with suspected sepsis, apnea, and diarrhea were found to have infant botulism, possibly from contact with soil on the clothing of family members. 16 Botulism occurs in sporadic cases and outbreaks occur worldwide. 13 An average of 110 cases occur across the United States per year, of which 70% are infant cases and 25% are food borne.…”

mentioning

confidence: 99%

Soil-Related Bacterial and Fungal Infections

Baumgardner

2012

The Journal of the American Board of Family Medicine

104

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A variety of classic and emerging soil-related bacterial and fungal pathogens cause serious human disease that frequently presents in primary care settings. Typically, the growth of these microorganisms is favored by particular soil characteristics and may involve complex life cycles including amoebae or animal hosts. Specific evolved virulence factors or the ability to grow in diverse, sometimes harsh, microenvironments may promote pathogenesis. Infection may occur by direct inoculation or ingestion, ingestion of contaminated food, or inhalation. This narrative review describes the usual presentations and environmental sources of soil-related infections. In addition to tetanus, anthrax, and botulism, soil bacteria may cause gastrointestinal, wound, skin, and respiratory tract diseases that also should be considered, particularly in the case of wound, respiratory tract, or gastrointestinal infections. The purpose of this article is to review bacterial and fungal infections for which the source of contact is primarily the soil (eg, Clostridium tetani) or for which soil is an important or emerging secondary site of contact (eg, Legionella). The emphasis of this article will be on the epidemiology of significant soil-related human pathogens and their common disease presentations such that these entities will be considered promptly during relevant patient evaluations. (The reader is referred to recent texts and manuscripts for details regarding unusual presentations and the diagnosis and treatment of these infections and for discussion of superficial soil-related infections, such as dermatophyte infections, which will not be covered here.) Soil MicrobiologySoil 1,3 is a multilayered surface complex of mineral and organic (humus) constituents present in solid, liquid, and gaseous states. The mineral portion of soil results from the actions of weathering and erosion on rock. Broad soil type-sand, silt, or clay-is defined, largest to smallest, by particle size. These particles pack loosely, and pore spaces of varying sizes are formed. Particle surfaces, pore spaces, and plant roots are particular habitats for microorganisms, often in biofilms. Soil also contains plants, animals, carcasses, and man-made materials.The quantity and type of microorganisms in a particular portion of soil are determined by a complex interaction of varying amounts of sunlight, temperature, moisture, soil pH, nutrients, and reThis article was externally peer reviewed.

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“…Die Infektion von Säuglingen stellt heute die häufigste Botulismusform dar und tritt meist in den ersten 6 Lebensmonaten auf [12]. Er kann bereits im Neugeborenenalter vorkommen [18]; Anhalt für Plazentagängigkeit des Toxins besteht nicht [12]. In Deutschland werden pro Jahr ca.…”

Section: Säuglingsbotulismusunclassified

Säuglingsbotulismus und plötzlicher Kindstod: Eine kritische Bestandsaufnahme

Bartram

Singer²

2004

Klin Padiatr

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Infant botulism represents a distinct entity of botulism. Ingestion of the ubiquitously present spores of Clostridium botulinum leads to germination of the organism and neurotoxin production in the infant intestine. Symptoms typically develop gradually in contrast to classical food botulism in which an acute onset of symptoms shortly after the ingestion of preformed toxin in a food is characteristic. Microbiologically, the diagnosis is established by identification of Clostridium botulinum organism and toxin in stool specimen. However, positive results in these tests provide only indirect evidence for the clinical relevance of the neurotoxin since asymptomatic carriers have been found. The toxin irreversibly blocks the release of acetylcholin from the motoric end plate which results in muscle weakness and paralysis. Depending on the amount of toxin produced, infant botulism exhibits a broad clinical spectrum ranging from oligosymptomatic forms to a fulminant course with acute respiratory failure within hours leading to sudden death. Unrecognized mild forms or beginning muscle weakness can be a co-factor for other risk factors of sudden infant death (SIDS). In studies analyzing infants who died from SIDS, botulism bacteria or toxin were found in up to 20 % of cases. Infant botulism therefore represents an important differential diagnosis of unexplained and inconclusive muscular hypotonia in the first year of life.

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Early severe infantile botulism

Cited by 21 publications

References 7 publications

Infant botulism

Infant botulism

Soil-Related Bacterial and Fungal Infections

Säuglingsbotulismus und plötzlicher Kindstod: Eine kritische Bestandsaufnahme

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