On initial presentation, the typical patient has some or all of theįollowing findings: ptosis (which may not be evident until the infants head is heldĮrect), weak cry, diminished suck and gag, drooling and/or pooling of saliva, dilatedĪnd/or sluggishly reactive pupils, disconjugate gaze, blunted facial expression, poor headĬontrol, decreased anal sphincter tone, hypotonia and generalized weakness. Generalized weakness, hypotonia and respiratory difficulty when first seen. Somatic musculature is affected next, and patients with rapidly evolving illness may have Toxin produces a flaccid motor paralysis that invariably begins in the bulbar musculature. See Nevas et al., Journal of Clinical Microbiology,Ģ005 Mitchell W, Tseng-Ong L, Pediatrics 2005 116 436-438 and Hurst and Marsh, The Journal of Pediatrics, 122(6):909-911, 1993.īecause botulinum toxin binds at the neuromuscular junction, the May become more noticeable, which is sometimes attributed to teething rather than to dysphagia.Ī "catastrophic" presentation of infant botulism with a paucity of the usual clinical signs has also been recognized.
Respiratory effort may become shallow and rapid, and the cry is feeble. The breast-feeding mother may notice breastĮngorgement because the babys suck is weak. Generally, parentsįirst notice that the baby feeds poorly. Of illness is constipation (defined as decreased frequency in defecation),Īlthough this sign is frequently overlooked by parents and physicians. Infant botulism can only be detected by careful observation.
Examination Signs Helpful in the Diagnosis of Infant Botulismīecause infants are unable to describe their symptoms, the onset of
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