First Case of Infant Botulism in Sicily - Case Report

Abstract

Abstract Background Botulism is a rare and life-threatening disease caused by the potent botulinum neurotoxin (BoNT), which can be produced by Clostridium botulinum (C. botulinum) and related bacteria. Clinical manifestations, which include a symmetrical, descending muscular paralysis, generalized hypotonia, and potentially respiratory failure, are non-specific and diagnosis is challenging, especially when anamnesis does not reveal any typical risk factor, like honey consumption. Case Presentation: We present the first documented case of infant botulism (IB) in Sicily and provide and discuss the challenges posed by this complex condition. The infant, exclusively breastfed and without known exposure to honey, presented with poor suction, hypotonia, and hyporeactivity. A thorough investigation revealed a history of constipation and exposure to dust from home renovation works, leading to the suspicion of botulism. The botulinum antitoxin was administered and the diagnosis was confirmed through fecal examination, detecting toxin-producing C. botulinum. Conclusion IB should be considered in every infant with rapidly progressing hypotonia and a history of constipation. The transmission could occur through the inhalation of dust particles containing the toxin, highlighting the importance of exploring diverse sources of exposure. Timely diagnosis and treatment played a crucial role in the successful outcome, demonstrating the significance of early intervention in managing IB.