A previously healthy 6-month-old boy is brought to the emergency department because of irritability and poor feeding for 6 days. He has also not had a bowel movement in 9 days and has been crying less than usual. He is bottle-fed with formula and his mother has been weaning him with mashed bananas mixed with honey for the past 3 weeks. His immunizations are up-to-date. He appears weak and lethargic. He is at the 50th percentile for length and 75th percentile for weight. Vital signs are within normal limits. Examination shows dry mucous membranes and delayed skin turgor. There is poor muscle tone and weak head control. Neurological examination shows ptosis of the right eye. Which of the following is most likely to confirm the diagnosis in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Infant botulism can result from consumption of honey, which frequently contains C botulinum spores that can germinate and produce botulinum toxin.  Symptoms of infant botulism include constipation, mild weakness, lethargy, poor feeding, and, in severe cases, flaccid paralysis.  The diagnosis can be confirmed by identification of C botulinum spores or toxins in the stool.

A Previously Healthy 6-Month-Old Boy Is Brought to the Emergency