Two Cases of Type E Infant Botulism Caused by Neurotoxigenic Clostridium butyricum in Italy

ArticleinThe Journal of Infectious Diseases 154(2):207-11 · September 1986with14 Reads
Impact Factor: 6.00 · DOI: 10.1093/infdis/154.2.207 · Source: PubMed


    The first two confirmed cases of type E infant botulism occurred in two 16-week-old girls in Rome, Italy. The original diagnosis
    for the first patient was intestinal blockage due to an ileocecal invagination, which was treated surgically. Postoperatively,
    the patient became unresponsive and required ventilatory assistance. A diagnosis of infant botulism was then made. The second
    infant presented to the same hospital 7½ months later with profound weakness, hypotonicity, mydriasis, and areflexia. This
    case was recognized as possible botulism at admission. Both cases were confirmed by detection and identification of type E
    botulinal toxin in stool specimens and in enrichment cultures of those specimens. The toxigenic organisms isolated were quite
    different from Clostridium botulinum type E. The apparent causative organism in each case resembles Clostridium butyricum but produces a neurotoxin that is indistinguishable from type E botulinal toxin by its effects on mice and by its neutralization
    with type E botulinal antitoxin.