{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:40:19Z","timestamp":1756374019128,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,13]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Infant botulism is a rare but life-threatening neuroparalytic syndrome caused by intestinal colonisation of <jats:italic>Clostridium botulinum<\/jats:italic> resulting in a symmetrical descending flaccid paralysis. This gram-positive, rod-shaped anaerobic bacillus is universally found in soil with previous links to ingestion of honey and dust contaminated with <jats:italic>C. botulinum<\/jats:italic> spores. We present a case of a baby boy with this rare condition eventually linked to dust on a rural outback property. This young patient was ventilated for 90 days. Initial serology for botulism toxin was negative, although <jats:italic>C. botulinum<\/jats:italic> spores were eventually grown in the stool. The patient did not receive early treatment with Human Botulism Immune Globulin Intravenous (BIG-IV) as there was a low index of suspicion and a delay in obtaining a stool sample for nearly 6\u2009weeks due to constipation. This case highlights the importance of early treatment with BIG-IV when clinical features and environmental conditions in the remote Australian outback favour persistence of <jats:italic>C. botulinum<\/jats:italic> spores in soil without awaiting confirmatory tests.<\/jats:p>","DOI":"10.1136\/bcr-2024-262942","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T23:55:40Z","timestamp":1740441340000},"page":"e262942","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Dry and dusty outback: infant botulism"],"prefix":"10.1136","volume":"18","author":[{"given":"Patricia","family":"Grant","sequence":"first","affiliation":[{"name":"NETS, New South Wales Newborn and Paediatric Emergency Transport Service, Bankstown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5092-9774","authenticated-orcid":false,"given":"Alexandra A","family":"Legge","sequence":"additional","affiliation":[{"name":"NETS, New South Wales Newborn and Paediatric Emergency Transport Service, Bankstown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aranzazu","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Paediatrics, Broken Hill Base Hospital, Broken Hill, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn Browning","family":"Carmo","sequence":"additional","affiliation":[{"name":"NETS, New South Wales Newborn and Paediatric Emergency Transport Service, Bankstown, New South Wales, Australia"},{"name":"Faculty of Medicine, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"2025082802213723000_18.2.e262942.1","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jpeds.2020.08.013","article-title":"Descriptive Epidemiology of Infant Botulism in California: The First 40 Years","volume":"227","author":"Panditrao","year":"2020","journal-title":"J Pediatr"},{"key":"2025082802213723000_18.2.e262942.2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1128\/CMR.9.2.119","article-title":"Update: infant botulism","volume":"9","author":"Midura","year":"1996","journal-title":"Clin Microbiol Rev"},{"key":"2025082802213723000_18.2.e262942.3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0297"},{"key":"2025082802213723000_18.2.e262942.4","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/S0022-3476(09)90016-6","article-title":"Early severe infantile botulism","volume":"122","author":"Hurst","year":"1993","journal-title":"J Pediatr"},{"key":"2025082802213723000_18.2.e262942.5","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1504\/TBJ.2015.078132","article-title":"Botulism mortality in the USA, 1975-2009","volume":"3","author":"Jackson","year":"2015","journal-title":"Botulinum J"},{"key":"2025082802213723000_18.2.e262942.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197609302951407"},{"key":"2025082802213723000_18.2.e262942.7","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1979.02130060020002"},{"key":"2025082802213723000_18.2.e262942.8","doi-asserted-by":"crossref","unstructured":"NNDSS Annual Report Working Group . 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