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Abstract Sir.—Since the first reports of infant botulism from the United States in 1976,1,2 cases have been identified on three additional continents—Australia,3,4 Europe,5,6 and South America.7 We now present the first laboratory-confirmed case of infant botulism to be recognized in Asia. Patient Report.—A male infant weighed 3200 g at birth on March 4, 1986, after a full-term, uncomplicated pregnancy. He was half breast-fed and half formula-fed, and developed normally. From May 1, honey added to homemade apple juice was occasionally fed to him until the time he was hospitalized. He became constipated on May 5, and an enema was given thereafter every four to five days. On May 25, he was brought to the emergency room because of difficulty swallowing, irritability, and lethargy, and was admitted. He was tachycardic and afebrile. He appeared drowsy and had a weak, constant cry. He showed generalized hypotonicity and diminished References 1. Pickett J, Berg B, Chaplin E, et al: Syndrome of botulism in infancy: Clinical and electrophysiologic study . N Engl J Med 1976;295: 770-772.Crossref 2. Midura TF, Arnon SS: Infant botulism: Identification of Clostridium botulinum and its toxins in feces . Lancet 1976;2:934-936.Crossref 3. Murrell WG, Pivroer RA, Stewart BJ, et al: Infant botulism in a breast-fed infant from rural New South Wales . Med J Aust 1981;1:583-585. 4. Douglas HM, Manson JI, Paton JC, et al: Infant botulism . Med J Aust 1980;2:398. 5. Turner HD, Brett EM, Gilbert RJ, et al: Infant botulism in England . Lancet 1978;1: 1277-1278.Crossref 6. Neubauer M, Milácek V: Infant botulism type B in central Europe . Zentralbl Bakteriol Mikrobiol Hyg A 1981;250:540-547. 7. Arnon SS: Infant botulism: Anticipating the second decade . J Infect Dis 1986;154:201-206.Crossref 8. Johnson RO, Clay SA, Arnon SS: Diagnosis and management of infant botulism . AJDC 1979;133:586-593. 9. Ying S, Shuyan C: Botulism in China . Rev Infect Dis 1986;8:984-990.Crossref
American Journal of Diseases of Children – American Medical Association
Published: Feb 1, 1988
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