More Clinical Mimics of Infant Botulism - 31/01/18
Abstract |
Objective |
To ascertain the actual diagnoses of 76 patients (2005-2015) whose clinical presentations so closely resembled infant botulism that the patients were treated with Human Botulism Immune Globulin Intravenous (BIG-IV; BabyBIG), but whose illnesses subsequently were not laboratory confirmed as infant botulism (“clinical mimics” of infant botulism).
Study design |
The California Department of Public Health produces BIG-IV and distributes it nationwide as a public service (ie, not-for-profit) orphan drug to treat patients hospitalized with suspected infant botulism. During the study period, admission records and discharge summaries for all patients treated with BIG-IV but who lacked a laboratory-confirmed diagnosis of infant botulism were collected and abstracted. The patients' discharge diagnoses were identified, categorized, and compared with previously reported clinical mimics categories for 32 patients (1992-2005).
Results |
From 2005 to 2015, 76 clinical mimic illnesses were identified. These illnesses were distributed into the 5 categories previously reported of (1) probable infant botulism lacking confirmatory testing (26.3%); (2) spinal muscular atrophy (19.7%); (3) miscellaneous (15.8%); (4) metabolic disorders (11.8%); and (5) other infectious diseases (10.6%). Of the 76 clinical mimic illnesses, 15.8% had no alternate diagnosis established and were therefore categorized as undetermined.
Conclusions |
Over the 23 years 1992-2015, patients presenting with illnesses so clinically similar to infant botulism that they were treated with BIG-IV had actual diagnoses that were distributed into 5 main categories. These categories and their individual components constitute a working bedside differential diagnosis of infant botulism.
Le texte complet de cet article est disponible en PDF.Keywords : botulinum neurotoxin, botulism, differential diagnosis, human botulism immune globulin, infant botulism, metabolic disorders, orphan drug, rare diseases, spinal muscular atrophy type 1
Abbreviations : BIG-IV, BoNT, CDPH, EMG/NCS, SMA
Plan
Supported by the Infant Botulism Treatment and Prevention Fund of the California Department of Public Health. The authors declare no conflicts of interest. |
Vol 193
P. 178-182 - février 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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