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Volume 29, Number 2—February 2023
CME ACTIVITY - Synopsis

Infant Botulism, Israel, 2007–2021

Bar Goldberg, Dana Danino, Yoel Levinsky, Itzhak Levy, Rachel Straussberg, Halima Dabaja-Younis, Alex Guri, Yotam Almagor, Diana Tasher, Daniel Elad, Zina Baider, Shlomo Blum, and Oded ScheuermanComments to Author 
Author affiliations: Schneider Children’s Medical Center, Petach Tikva, Israel (B. Goldberg, Y. Levinsky, I. Levy, R. Straussberg, O. Scheuerman); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (B. Goldberg, I. Levy, R. Straussberg, D. Tasher, O. Scheuerman); Soroka Medical Center, Beer Sheva, Israel (D. Danino); Faculty of Health Sciences, Ben-Gurion University, Beer Sheva (D. Danino); Rambam Medical Center, Haifa, Israel (H. Dabaja-Younis); The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel (H. Dabaja-Younis); Kaplan Medical Center, Rehovot, Israel (A. Guri); Hadassah Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem (A. Guri); Meuhedet Healthcare, Jerusalem, Israel (Y. Almagor); Wolfson Medical Center, Holon, Israel (D. Tasher); National Reference Laboratory for Botulism, Kimron Veterinary Institute, Bet Dagan, Israel (D. Elad, Z. Baider, S. Blum)

Main Article

Table 2

Clinical features, diagnosis, and course of infant botulism patients, Israel, 2007–2021*

Category Value
Clinical feature, no. positive/no. tested
Respiratory distress 3/8
Ptosis 6/8
Facialis 1/8
Poor feeding 7/8
Descending paralysis 6/8
Depressed tendon reflexes 4/6
Hypotonia 8/8
Constipation 7/8
Hoarseness 3/8
Aspiration or decreased gag reflex 4/8
Weak cry 7/8
Lack of smile 4/8
Drooling 1/8
Mydriasis
 2/8
Diagnostic tool used, no. positive/no. tested
Electromyographic test 3/4
Toxin A 3/8
Toxin B 5/8
Stool PCR 2/2
EndoPep-MS 2/2
Mouse lethality bioassay
 7/8
Course of illness, d, median (range)
Time to resolution 75 (16–180)
Duration of nasogastric tube support† 11 (10–27)
Duration of intubation‡ 11.5 (2–21)
Duration of ICU stay§ 10.5 (11–30)
Duration of hospitalization 16 (11–30)
Time to diagnosis 9.5 (4–35)

*EndoPep-MS, mass spectrometric–based endopeptidase assay for detecting and differentiating botulinum neurotoxin serotypes; ICU, intensive care unit. †5/8 patients were supported by feeding tube. ‡2/8 patients were intubated. §4/8 patients were admitted to ICU.

Main Article

Page created: December 01, 2022
Page updated: January 20, 2023
Page reviewed: January 20, 2023
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