title: Infantile botulism: a case report and review.
abstract: BACKGROUND
  Infantile botulism is the result of ingestion of Clostridium botulinum spores, and is the most common form of infection with botulism in the United States. Ninety percent of cases occur in infants <6 months old. The infants typically present with vague symptoms such as hypotonia and poor feeding. This article reports an infant with confirmed infantile botulism that presented to the Emergency Department (ED) with complaints of decreased feeding and absence of bowel movements for >1 week.
  
  
  OBJECTIVE
  Review a case of infantile botulism, its diagnosis, and treatment.
  
  
  METHODS
  A 4-month-old healthy Caucasian male presented to the ED with a 6-day history of decreased feeding after referral from the pediatrician. He had not had a bowel movement for 9 days, and his parents were also concerned about increasing weakness, as he was no longer able to hold his head up on his own. In the ED, he was minimally interactive. His vital signs were within normal limits, and he had hypoactive bowel sounds and decreased tone throughout. He was admitted to the Children's Hospital and eventually transferred to the Pediatric Intensive Care Unit requiring intubation and mechanical ventilation. The botulism immunoglobulin was administered, and a diagnosis was confirmed with positive botulinum toxin in the stool samples. Full recovery was made by the infant.
  
  
  CONCLUSIONS
  Awareness of the symptoms of botulism and a high degree of clinical suspicion is needed to make a prompt diagnosis.
authors.affiliation: Department of Pediatrics, University of Louisville, Louisville, Kentucky.
authors.forename: Nicole
authors.initials: N
authors.lastname: Brown
authors.forename: Sameer
authors.initials: S
authors.lastname: Desai
mesh_terms: D001905:Botulinum Toxins / Q000097:blood; D001906:Botulism / Q000175:diagnosis* / Q000188:drug therapy; D003014:Clostridium botulinum / Q000302:isolation & purification*; D003248:Constipation / Q000175:diagnosis; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007223:Infant; D008297:Male; D018908:Muscle Weakness / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D007136:Immunoglobulins; D001905:Botulinum Toxins
keywords: Clostridium; botulinum; botulism; infantile