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Botulism, a rare life-threatening toxemia, is probably underdiagnosed in all of its forms in Africa. This study reports the first laboratory-supported case of infant botulism on the African continent. A 10-week-old, previously well infant presented with progressive global weakness, feeding difficulty, and aspiration pneumonia. During a lengthy hospitalization, a rare bivalent Clostridium botulinum strain, producing subtype B3 and F8 toxins and with a new multilocus sequence type, was isolated from stool. The infant was successfully treated with a heptavalent botulinum antitoxin infusion and pyridostigmine. Despite the relative rarity of infant botulism, this case illustrates the importance of maintaining a high level of clinical suspicion when assessing hypotonic infants. The value of modern diagnostic modalities in identifying and characterizing this under-recognized condition is also demonstrated. Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.


Marné N Vosloo, Christoffel J Opperman, Hermanus D W Geyer, Grace M Setshedi, Mushal Allam, Stanford Kwenda, Arshad Ismail, Zamantungwa T H Khumalo, Adrian J Brink, John A Frean, Jennifer Rossouw. First confirmed case of infant botulism in Africa, caused by a dual-toxin-producing Clostridium botulinum strain. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021 Feb;103:164-166

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PMID: 33212262

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