Infant botulism: first two confirmed cases in Slovenia and literature review

Abstract

In Europe, infant botulism is a rare but probably under-diagnosed disease. With the intent to spread the awareness of this potentially life-threatening disease, we present a review of the literature with the emphasis on European epidemiology and a practical approach to diagnosis. We also report the first two confirmed cases of infant botulism in Slovenia and describe our way to the final diagnosis in a clinical setting where all appropriate diagnostic tests and treatment options are not readily available. The second case is particularly interesting, presenting with profound diarrhea following initial constipation, an unlikely symptom for an infant with botulism and possibly caused by Bacteroides fragilis.

Keywords: Acute infant hypotonia; Bacteroides fragilis; Botulinum toxin; CB; Clostridium botulinum; Diarrhea; IB; Infant botulism; infant botulism.