Infant botulism: is there an association with thiamine deficiency?

Ringe, H., Schuelke, M., Weber, S., Dorner, B. G., Kirchner, S. and Dorner, M. B. (2014) Infant botulism: is there an association with thiamine deficiency? Pediatrics, 134(5), e1436-e1440. (doi: 10.1542/peds.2013-3378) (PMID:25311602)

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Abstract

Infant botulism is an acute life-threatening condition and diagnosis is frequently delayed. Therefore, the best time window to administer specific antibodies, at present the only etiology-based therapy, is often missed, entailing long periods of hospitalization in the PICU. Here we present a 3-month-old boy with infant botulism and respiratory failure, who quickly and favorably responded to thiamine supplementation. From the feces we isolated Clostridium botulinum serotype A2. In addition to producing botulinum neurotoxin A, this strain carried the thiaminase I gene and produced thiaminase I. Accordingly, the child’s feces were positive for thiaminase I activity. Because C botulinum group I strains are capable of producing thiaminase I, we speculate that thiamine degradation might further aggravate the paralytic symptoms caused by botulinum neurotoxins in infant botulism. Thus, supportive supplementation with thiamine could be beneficial to speed up recovery and to shorten hospitalization in some patients with infant botulism.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Kirchner, Dr Sebastian
Authors: Ringe, H., Schuelke, M., Weber, S., Dorner, B. G., Kirchner, S., and Dorner, M. B.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Journal Name:Pediatrics
Publisher:American Academy of Pediatrics
ISSN:0031-4005
ISSN (Online):1098-4275
Published Online:31 October 2014

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