Infant botulism following honey ingestion

Abstract

An apparently well baby girl born at term was presented with signs and symptoms suggestive of acute onset of generalised floppiness at the age of 3 months. Clinically, the baby had lower motor neuron type of muscle weakness; detailed investigation lead to the diagnosis of neuromuscular junction disorder secondary to botulism toxicity. Further tests confirmed the botulism toxicity secondary to honey ingestion. The baby was treated with specific anticlostridium antibodies; she recovered remarkably, now growing and developing normally.

Figure 1

Stimulation single fibre electromyography (Stim SFEMG) study of right orbicularis oculi. The figure on the left shows a faster display of single fibre muscle action potentials and the right shows the superimposed display. The highlighted units (big white arrows) have an increased jitter measurement with mean consecutive difference (MCD) of 145 and 45 µs. The potential on the left is also blocking.