BOTULINUM TOXICITY IN INFANT THE FIRST SUCESSFULLY TREATMENT CASE IN VIETNAM

Ta Anh Tuan1, Pham Thi Thanh Tam1, Nguyen Thi Huyen Sam1, Nguyen Thi Thu Hang1, Pham Thu Nga1, Nguyen Thi Thu Nga2, Dinh Thi Van Anh1, Do Quang Vy1
1 Vietnam National Children s Hospital
2 Vietnam NAtional Children s Hospital

##plugins.themes.vojs.article.main##

Tóm tắt

Overview: Botulism infants is a potentially life-threatening disease caused by ingestion of
Clostridium botulinum spores, which germinate, multiply in the large intestine and produce neurotoxins to the body [1]. The disease occur in children under 12 months [2]. This is a rare form of infection in Vietnamese infants. The key features of presentation were acute onset of bilateral cranial nerve palsies and symmetrical descending weakness in the absence of fever. But sometime, patients have vague symptoms such as decreased muscle tone, poor feeding. This report will present a case of a 10-month-old admitted to the hospital with acute generalized hypotonia and aspiration. Objectives: Approach to diagnosis and treatment of botulism infants. Case study: A 10-month-old female was admitted to the Vietnam National Childrens Hospital (VNCH) because of difficulty sucking and swallowing. These signs were acute onset 2 days before.
The child had very little interaction, crying hoarsely, no tears and symmetrical descending
weakness. The clinical diagnosis of botulism was confi rmed through the identifi cation of
C. botulinumtoxin from the stool sample. The patient was given a single dose of botulinum
antitoxin and she had fully recovered.
Conclusion: Due to its rarity, diagnosing botulism is a challenge, demanding high clinical suspicion. Successful outcomes depend upon early recognition and rapid initiation of specific treatment with botulinum antitoxin. There is a need to improve global access to antitoxin. These case, the fi rst botulism infant in Viet Nam, serve as a reminder of the need to diff erential diagnosis with other acute peripheral paralysis.

##plugins.themes.vojs.article.details##

Tài liệu tham khảo

1. https://www.cdc.gov/botulism/surv/2017/
index.html.
2. Rasetti-Escargueil C, Lemichez E, Popoff
MR: Human botulism in France, 18752016. Toxins
(Basel). 2020; 12(5): 338.
PubMed Abstract| Publisher Full Text| Free Full
Text.
3. Peck MW, Smith TJ, Anniballi F, et al:
Historical perspectives and guidelines for
botulinum neurotoxin subtype nomenclature.
Toxins (Basel). 2017; 9(1): 38.
PubMed Abstract| Publisher Full Text| Free Full
Text.
4. Hughes JM, Blumenthal JR, Merson MH, et
al: Clinical features of types A and B food-borne
botulism. Ann Intern Med. 1981; 95(4): 442-5.
PubMed Abstract| Publisher Full Text.
5. Dhaked RK, Singh MK, Singh P, et al.:
Botulinum toxin: Bioweapon & magic drug.
Indian J Med Res. 2010; 132(5): 489–503.
PubMed Abstract|Ftion
6. Nguyen Thi Thuy Ngan, Vo Ngoc Anh Tho,
et al: Botulismoutbreak after the consumption of
vegetarian pâtéin the south of Viet Nam. 2020;
The  Oxford University Clinical Research Unit
(OUCRU) gateway.
7. Larry M. Bush, Marria T. Vazquez-Pertejo
(2021), Infant Botulism-Infectious diseases-MSD
manual professional edition.
8. Olaf A Bodamer (2021). Infant Botulism -
Neoromuscular junction disorders in newborns
and infants.https: //www.uptodate.com/
contents/ neuromuscular - junction - disorders -
in- newborns - and - infants.
9. Merz B, Bigalke H, Stoll G, et al.: Botulism
type B presenting as pure autonomic dysfunction.
Clin Auton Res. 2003; 13(5): 337–8.
PubMed Abstract|Publisher Full Text.
10. Adams DZ, King A, KaideC: Cranial
Neuropathies and Neuromuscular Weakness: A
Case of Mistaken Identity.Clin Pract Cases Emerg
Med. 2017; 1(3): 238–241.
PubMed Abstract|Publisher Full Text| Free Full
Text.
11. Chalk CH, Benstead TJ, KeezerM: Medical
treatment for botulism.Cochrane Database Syst
Rev. 2014; 4(4): CD008123.
PubMed Abstract|Publisher Full Text| Free Full
Text.ree Full Text.