Abstract
Botulism is a serious intoxication caused by ingestion of food containing preformed botulinus toxin and characterized by rapidly progressive bulbar paralysis, generalized weakness, and respiratory insufficiency. In 1976 a distinct clinical entity of infant botulism was recognized. The disease apparently results from intraintestinal toxin production which produces a defect in neuromuscular transmission by interfering with release of acetylcholine at cholinergic synapses. Five cases of infant botulism were identified at the Children's Hospital of Philadelphia between 1975 and 1977. Initial symptoms included constipation, slow feeding, lethargy and weak cry. Four of the patients progressed to respiratory insufficiency requiring nasotracheal intubation. Three of the infants with respiratory failure required tracheotomy. Because infants with respiratory failure may require support for months, we recommend that a tracheotomy be performed early in the management to avoid the complications associated with prolonged intubation. The effectiveness of antitoxin or antibiotics to treat infant botulism remains questionable and therefore prolonged respiratory supportive care is the mainstay of therapy. In addition, we offer guidelines for dec...Continue Reading
References
Jun 1, 1978·Archives of Neurology·H H Schiller, E Stålberg
Dec 1, 1978·Journal of Clinical Chemistry and Clinical Biochemistry. Zeitschrift Für Klinische Chemie Und Klinische Biochemie·H Keller
Sep 30, 1976·The New England Journal of Medicine·J PickettM A Brunstetter-Shafer
Mar 1, 1977·The Laryngoscope·D B Hawkins
Jun 1, 1977·Archives of Otolaryngology·R M Strong, V Passy
Feb 1, 1975·Neurology·G JenzerF Robert
Jan 1, 1975·International Anesthesiology Clinics·J Wolfsdorf
Jan 1, 1971·Neurology·M Cherington, S Ginsberg
Apr 1, 1974·Developmental Medicine and Child Neurology·W D GroverP H Berman
Oct 24, 1974·The New England Journal of Medicine·M Javid
Sep 2, 1974·JAMA : the Journal of the American Medical Association·M H MersonE J Gangarosa
Jun 1, 1974·Archives of Neurology·M Cherington
Oct 1, 1971·The Annals of Otology, Rhinology, and Laryngology·B Fearon, D Ellis
Aug 1, 1972·The Laryngoscope·G R Freeman
Jan 22, 1970·The New England Journal of Medicine·M Cherington, D W Ryan
Apr 2, 1970·The New England Journal of Medicine·T A Neff
Apr 25, 1968·The New England Journal of Medicine·M Cherington, D W Ryan
Aug 1, 1971·The Annals of Otology, Rhinology, and Laryngology·F H McGovernL J Edgemon