Infant botulism

Symptoms:

• The first and most frequent symptom is constipation.
• muscle weakness and floppiness (hypotonia)
• weak cry (due to muscle weakness)
• poor feeding and weak suck (due to muscle weakness)
• infant doesn't gag (absent or decreased gag reflex)
• respiratory distress (due to muscle weakness)
• eyelids sag or partially close (ptosis) (due to muscle weakness)
• descending paralysis
• respiratory failure (rare in children not sick enough to be hospitalized)

Signs and tests:

Physical examination shows decreased muscle tone (hypotonia), an absent or decreased gag reflex, absent or decreased deep tendon reflexes, and eyelid drooping (ptosis).

Laboratory testing consists of checking a stool sample to demonstrate the presence of botulinum toxin in the stool or demonstration of the organism, C. botulinum in the stool. Stool toxin studies commonly are not availble through local hospitals, but are available through state departments of health and the Centers for Disease Control.Electromyography can differentiate between muscle abnormalities and neurologic abnormalities