Baby with respiratory problems and cardiac arrest

A ten-month-old girl was admitted to hospital with respiratory and gastrointestinal symptoms. Her condition deteriorated the following day, and she presented with symptoms of inspiratory stridor, facial palsy and ventricular fibrillation. She was resuscitated and intubated, and a normal spinal puncture was performed. Further investigation revealed areflexia, general hypotonia and reduced ejection fraction. Neurophysiological investigation showed long F-response, and renewed cerebrospinal fluid testing showed albuminocytologic dissociation, both typical signs of acute inflammatory demyelinating polyneuropathy (AIDP). Antitoxin was administered to the baby on suspicion of botulism, but immunological and microbiological testing ruled out infectious aetiology. She showed rapid improvement after i.v. immunoglobulin therapy, and was completely restituted/recovered 6 months after the incident.