Neonatal Botulism: A Case Series Suggesting Varied Presentations

Pediatr Neurol. 2023 Sep:146:40-43. doi: 10.1016/j.pediatrneurol.2023.06.004. Epub 2023 Jun 14.


Infantile botulism is an uncommon diagnosis and rarer still in the neonatal period. We describe three cases of neonatal-onset botulism that presented with symptoms typically (hypotonia, constipation, facial diplegia) or atypically seen in older infants (encephalopathy, seizures, and hypothermia). Our series shows a wider spectrum of clinical presentations in patients with neonatal-onset botulism. Our report also suggests that neonatal-onset botulism should be considered more broadly in the hypotonic infant, especially as the condition is treatable with intravenous botulinum-specific immune globulin.

Keywords: Botulinum toxin; Botulism; Neonatal; Neuromuscular; Respiratory distress.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Antibodies
  • Botulism* / diagnosis
  • Botulism* / therapy
  • Clostridium botulinum*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases*


  • Antibodies
  • Immunoglobulins, Intravenous