Infant botulism, type F, presenting at 54 hours of life

Keet, Corinne A.; Fox, Christine K.; Margeta, Marta; Marco, Elysa; Shane, Andi L.; DeArmond, Stephen J.; Strober, Jonathan B.; Miller, Steven P.

doi:10.1016/j.pediatrneurol.2004.09.003

« Previous Next »Pediatric Neurology
Volume 32, Issue 3 , Pages 193-196, March 2005

Infant botulism, type F, presenting at 54 hours of life

Corinne A. Keet, MD, MS
- Communications should be addressed to:Dr. Miller; University of California at San Francisco; 521 Parnassus Avenue; Room C-215; San Francisco, CA 94143-0663.
- University of California, San Francisco (UCSF) School of Medicine, San Francisco, California
- These authors contributed equally to this work.
Christine K. Fox, MD
- University of California, San Francisco (UCSF) School of Medicine, San Francisco, California
- These authors contributed equally to this work.
Marta Margeta, MD, PhD
- Neuropathology Unit, Department of Pathology, UCSF, San Francisco, California
Elysa Marco, MD
- Division of Child Neurology, Department of Neurology, UCSF, San Francisco, California
Andi L. Shane, MD, MPH
- Division of Pediatric Infectious Diseases, Department of Pediatrics, UCSF, San Francisco, California.
Stephen J. DeArmond, MD, PhD
- Neuropathology Unit, Department of Pathology, UCSF, San Francisco, California
Jonathan B. Strober, MD
- Division of Child Neurology, Department of Neurology, UCSF, San Francisco, California
Steven P. Miller, MD
- Division of Child Neurology, Department of Neurology, UCSF, San Francisco, California

Received 11 June 2004; accepted 8 September 2004. published online 17 December 2004.

We report a case of botulism in a 54-hour-old infant with rapidly progressive fulminant paralysis and rapid spontaneous recovery atypical for infant botulism. Clostridium baratii and type F botulinum neurotoxin were isolated from the patient’s stool. This unique presentation with rapid recovery is consistent with pharmacokinetics of type F botulinum neurotoxin. Interestingly, a muscle biopsy also revealed pathologic changes early in the disease course. This article reports the youngest known case of infant botulism and only the third reported case of this disease caused by type F neurotoxin. Botulism should be considered in patients of any age with subacute or acute neuromuscular weakness.