It typically presents between the ages of 2 and 6 months of age with almost all patients demonstrating generalized weakness with limb involvement and hyporeflexia. Constipation is also frequently observed. Less consistent findings are facial and bulbar weakness, sluggish pupils, autonomic instability, and respiratory compromise. Honey should not be given to children less than one year of age as the intestinal flora of infants is susceptible to colonization with Clostridium botulinum. Management of infantile botulism is mainly supportive in nature with close attention to pulmonary care and respiratory status.
Some patients do require mechanical ventilation and tracheostomy placement.
There has also been recent development of a human-derived botulism immune globulin, which shows promise in hastening resolution of symptoms. Disorders of neuromuscular transmission in infants and children. Clinical electrophysiology of infantile botulism. Dumitru D. Electrodiagnostic Medicine. Electrophysiologic correlates of peripheral nerve maturation in infancy and childhood.