Abstract
Background Though botulism is a rare disease overall, all infants younger than 1 year of age
are at risk of contracting infant botulism, the most prevalent form reported in the
United States. Nonetheless, infant botulism is frequently omitted from the differential
diagnosis of the very young neonate exclusively due to age, and the diagnosis is often
only considered secondarily after a costly and prolonged work up is undertaken. Delayed
diagnosis can lead not only to unnecessary testing but also to prolonged hospital
stay and increased morbidity.
Case This case series highlights three critically ill neonates, all younger than 30 days,
who presented to our neonatal intensive care unit and were eventually diagnosed with
infant botulism. The initial diagnostic dilemma is described for each of these patients
and highlights the importance of early recognition of the main symptoms, in addition
to consideration of important potential coinciding conditions.
Keywords
neonatology - infant botulism - BIG-IV
