956 Infant Botulism Due to Honey Ingestation

Background and Aims Botulism is a neuroparalytic disease caused by neurotoxins produced by the bacteria Clostridium botulinum. This neurotoxin inhibits the normal release of acetylcholine in the synaptic cleft, inducing presynaptic neuromuscular blockade. Infant botulism results from the absorption of heat-labile neurotoxin produced in situ by ingested Clostridium botulinum. Honey and environmental exposure are the main sources of acquisition of the organism. Patient The patient was a 6-month-old girl with bilateral ptosis, muscle weakness, constipation and history of honey consumption. Lumbar puncture (LP), electromyography (EMG), nerve conduction study (NVS) and brain magnetic resonance imaging (MRI) were performed that all were normal. Stool evaluation for botulinum toxin was positive for toxin-A. Due to delayed diagnosis and improvement of general condition with conservative management botulinum anti-toxins did not started for her. After several days symptoms graduallay improved and she was discharged with good general condition. Conclusion Botulinum should be considered in every patient with weakness and ptosis. Botulism evaluation and approporiate management should be done.