Logo of jcmPermissionsJournals.ASM.orgJournalJCM ArticleJournal InfoAuthorsReviewers
J Clin Microbiol. 1987 Dec; 25(12): 2334–2338.
PMCID: PMC269483

Examination of feces and serum for diagnosis of infant botulism in 336 patients.


In the 12-year period 1975 to 1987, feces from 336 infants were examined for botulinal neurotoxin and Clostridium botulinum. All the infants had illnesses which prompted their physicians to consider infant botulism in the diagnosis. Stool specimens from 113 of the infants yielded organisms that produced botulinal neurotoxins assumed to be responsible for the illness. The types of botulinal toxin in the confirmed cases were distributed as follows: 38 A, 69 B, 2 atypical B, 1 E, 1 F, 1 A + B, and 1 B + F. The type A and B toxins in a single infant were produced by two different strains of organism, and the type B and F toxins in another infant were produced by a single strain. The physiological characteristics of all the isolated toxigenic organisms except two were consistent with those of group I (proteolytic) C. botulinum. The toxigenic isolate from the infant with type E botulism was identified as C. butyricum, and that from the infant with type F botulism was identified as C. barati. Toxin of the same type as produced by the isolated organisms was identified in feces of 98 of 111 culture-positive infants. Botulinal toxin was identified in the serum of 9 of 67 culture-positive infants (8 of 22 infants with type A organisms; 1 of 43 infants with type B organisms; neither of 2 infants with A + B or atypical type B organisms). Botulinal toxin was not detected in feces (206 infants) or in serum (114 infants) of the culture-negative infants. The culture-positive infants had clinical features and a course of illness consistent with those of infant botulism. Most of the culture-negative infants probably had illnesses other than botulism, but specimens might have been obtained late in some infants' illnesses, when the organism had disappeared.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (876K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Arnon SS, Midura TF, Clay SA, Wood RM, Chin J. Infant botulism. Epidemiological, clinical, and laboratory aspects. JAMA. 1977 May 2;237(18):1946–1951. [PubMed]
  • Aureli P, Fenicia L, Pasolini B, Gianfranceschi M, McCroskey LM, Hatheway CL. Two cases of type E infant botulism caused by neurotoxigenic Clostridium butyricum in Italy. J Infect Dis. 1986 Aug;154(2):207–211. [PubMed]
  • Dezfulian M, Dowell VR., Jr Cultural and physiological characteristics and antimicrobial susceptibility of Clostridium botulinum isolates from foodborne and infant botulism cases. J Clin Microbiol. 1980 Jun;11(6):604–609. [PMC free article] [PubMed]
  • Dowell VR, Jr, McCroskey LM, Hatheway CL, Lombard GL, Hughes JM, Merson MH. Coproexamination for botulinal toxin and clostridium botulinum. A new procedure for laboratory diagnosis of botulism. JAMA. 1977 Oct 24;238(17):1829–1832. [PubMed]
  • Giménez DF, Ciccarelli AS. Studies on strain 84 of Clostridium botulinum. Zentralbl Bakteriol Orig. 1970;215(2):212–220. [PubMed]
  • Glasby C, Hatheway CL. Isolation and enumeration of Clostridium botulinum by direct inoculation of infant fecal specimens on egg yolk agar and Clostridium botulinum isolation media. J Clin Microbiol. 1985 Feb;21(2):264–266. [PMC free article] [PubMed]
  • Hall JD, McCroskey LM, Pincomb BJ, Hatheway CL. Isolation of an organism resembling Clostridium barati which produces type F botulinal toxin from an infant with botulism. J Clin Microbiol. 1985 Apr;21(4):654–655. [PMC free article] [PubMed]
  • Hatheway CL. Laboratory procedures for cases of suspected infant botulism. Rev Infect Dis. 1979 Jul-Aug;1(4):647–651. [PubMed]
  • Hatheway CL, McCroskey LM, Lombard GL, Dowell VR., Jr Atypical toxin variant of Clostridium botulinum type B associated with infant botulism. J Clin Microbiol. 1981 Dec;14(6):607–611. [PMC free article] [PubMed]
  • Hoffman RE, Pincomb BJ, Skeels MR. Type F infant botulism. Am J Dis Child. 1982 Mar;136(3):270–271. [PubMed]
  • McCroskey LM, Hatheway CL, Fenicia L, Pasolini B, Aureli P. Characterization of an organism that produces type E botulinal toxin but which resembles Clostridium butyricum from the feces of an infant with type E botulism. J Clin Microbiol. 1986 Jan;23(1):201–202. [PMC free article] [PubMed]
  • Pickett J, Berg B, Chaplin E, Brunstetter-Shafer MA. Syndrome of botulism in infancy: clinical and electrophysiologic study. N Engl J Med. 1976 Sep 30;295(14):770–772. [PubMed]
  • Thompson JA, Glasgow LA, Warpinski JR, Olson C. Infant botulism: clinical spectrum and epidemiology. Pediatrics. 1980 Dec;66(6):936–942. [PubMed]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)


Save items

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem chemical substance records that cite the current articles. These references are taken from those provided on submitted PubChem chemical substance records.

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...