A Case of Infant Botulism Treated with Human-Derived Antitoxin
Sara Jimeno Ruiz1,3,4 MD PhD, María Benedit Gómez1 MD, Paula Touza Pol1 MD PhD, Amaia García Arratibel2 MD and Alejandro López Escobar5* MD PhD
1Pediatrics Department, HM Hospitales, Madrid, Spain.
2Neurology Department, HM Hospitales, Madrid, Spain.
3HM Science Faculty, Camilo José Cela University, Madrid, Spain.
4Fundación de Investigación HM Hospitales, HM Hospitales.
5Pediatrics Department, Hospital Universitario General de Villalba, Madrid, Spain.
*Corresponding Author: Alejandro López Escobar, MD PhD, Pediatrics Department, Hospital Universitario General de Villalba, Madrid, Spain. https://orcid.org/0000-0002-9052-1429 Email: alejandro.lopeze[at]hgvillalba.es
DOI: https://doi.org/10.58624/SVOAPD.2024.03.061
Received: March 16, 2023 Published: April 24, 2024
Abstract
Background: Infant botulism is a severe and rare illness due to the ingestion of the neurotoxin secreted by Clostridium botulinum and is a neuroparalytic descendant acute disease which is reversible, treatable and preventable. Symptoms vary from mild hypotonia to respiratory failure and sudden death.
Clinical Observation: A four-months-old female baby taken to the Emergency Room because of hypoactivity and failure to eat. Parents reported constipation for the last 5 days. The physical examination showed a hypoactive baby with sleep tendency and mild axial hypotonia. During the next 48 hours there is a progressive worsening of the clinical condition with severe axial hypotonia, generalized weakness, weak cry, increasing difficulty in sucking and swallowing and increase of respiratory secretions together with weak cough reflex. An electromyogram was performed with normal results. Parents denied giving the baby honey, infusions or any other food other than milk or cereals. Although there was no clear epidemiological history, infant botulism was suspected, and contact was made with the local Health Department and a direct toxin analysis was requested from blood and fecal samples. She received treatment with human derived botulism antitoxin (BabyBIG®) with a favorable outcome. The diagnosis was confirmed by the detection of the botulism toxin B in the patient's stools.
Comments: Infant botulism, although it is a rare disease in our environment, requires a high level of suspicion to make an early diagnosis and initiate a timely and specific treatment and thus reduce complications and the course of the disease.
Keywords: Botulism, Hypotonia, Antitoxin, BabyBIG
Citation: Jimeno Ruiz S, Benedit Gomez M, Touza Pol P, García Arratibel A, Lopez Escobar A. A Case of Infant Botulism Treated with Human-Derived Antitoxin. SVOA Paediatrics 2024, 3:2, 30-37.