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Infant Botulism and Indications for Administration of Botulism Immune Globulin

Pifko, Elysha MD; Price, Amanda MD; Sterner, Sarah MD, FAAP, FACEP

doi: 10.1097/PEC.0000000000000079
CME Review Article

Infant botulism is caused by the ingestion of Clostridium botulinum spores and leads to a life-threatening descending motor weakness and flaccid paralysis in infant children. This disease presents with symptoms such as constipation, weakness, and hypotonia and can lead to respiratory failure. Botulism immune globulin (BIG) was created to treat this deadly disease and functions by neutralizing all systemically circulating botulism toxins. It is indicated in children with clinically diagnosed infant botulism, before diagnostic confirmation, and has been shown to lead to a significant reduction in intensive care unit and hospital stay for these patients. This review article discusses the epidemiology, clinical presentation, history of BIG, and indications for administration of BIG.

Resident Physician (Pifko), Pediatric Emergency Medicine Fellow (Price), Pediatric Emergency Medicine Attending Physician (Sterner), Medical University of South Carolina, Charleston, SC.

The authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Reprints: Elysha Pifko, MD, Medical University of South Carolina, 135 Rutledge Ave, MSC 566, Charleston, SC 29425 (e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.