Infant Botulism: An Unusual Cause of Intestinal Hypomotility

Infant botulism is a recently described syndrome of generalized hypotonicity in babies in whom Clostridium botulinum organisms and toxin have been isolated from the feces [1]. Since 1976 when the disease was first recognized , at least eight cases have been reported in California, and additional cases have been documented in other pants of the United States [2, 3]. Sudden onset of genenalized muscle weakness and regression of motor development in a previously healthy infant are characteristic of this disease [2]. Physical findings include ptosis, ophthalmoplegia, reduced facial expression, dysphagia, pooling of oral secretions, diminished gag reflex, and poor anal sphincter tone. Constipation secondary to intestinal hypomotility is a prominent part of this syndrome [3]. We report an infant with the botulism syndrome in whom intestinal hypomotility was associated with prolonged retention of barium following colon examination.