At times, certain beliefs may lead to serious complications, especially in cases of infants. In this article, Dr. Anuj Rastogi shares another success story of recovering a just born baby from botulism, in an emergency condition.

The case

A four-day-old baby was brought to my clinic. The infant was lethargic and was not moving its limbs. Its pupils were reacting but the Moro's reflex was absent. I immediately sent him for an MRI, but the reports were normal. Some other tests were also performed where all the reports were normal. 

We noted that the infant had a history of good crying at the time of birth and was handed over to the family in a normal condition. However, after 2 hours the baby began showing signs of lethargy and was transferred to a local hospital.

Patient history

After a lot of brainstorming, I spoke with the baby's father and he revealed that the baby was doing fine for two hours, it cried, was well fed, it responded properly, and everything was absolutely normal for the first two hours.

I tried to understand more from the father about the medication and whether the baby was fed anything else. The father then recalled that they fed raw honey to the baby as per their tradition. The honey was freshly extracted and obtained from a nearby village; that's when I got my cue.

Diagnosis

After listening about the honey the first thing that came to my mind was the condition of Botulism.

I also thought about non-convulsive status as a differential diagnosis but his EEG was normal, which confirmed Botulism as my diagnosis of exclusion. A metabolic panel test, septic screen, blood culture and CSF were done and all the reports were normal.

The baby was kept under close monitoring and observation and we continued with oral gastric feeding and physiotherapy. The baby eventually started to respond and within 2 days and started recovering. On the 15th day of admission, fortunately, I was able to discharge the baby.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author is a practising paediatrician from Meerut.