Plötzlicher Tod bei Zwillingen: Botulismus durch Kontamination von Gemüsebrei

Abstract

Botulism is caused by the blockage of the neural transmission in the cholinergic synapses by botulinum neurotoxin (BoNT) which is produced by Clostridium botulinum or other Clostridia. The classic form of botulism occurs after the ingestion of food contaminated by BoNT. The course of the infection can be asymptomatic, mild with subtle paralysis ("failure to thrive") oder severe with generalized paralysis ("floppy infant"). Infected infants can also die sudden and unexpectedly. These deaths often are attributed to Sudden Infant Death Syndrome (SIDS), unless a thorough postmortem examination reveals Botulism. The rate of fatal Botulism falsely attributed to SIDS is not known, because it is difficult in most cases to show the causal relationship between contamination, disease and death. We report the sudden and unexpected simultaneous death of twins of 22 months which could be attributed to Botulism. Contamination of food, colonization of the gut by Clostridia and infection with specific pathomorphological changes could be proven. The initial suspicion of infanticide could be excluded. lt could be shown, that Botulism is a potential cause of simultaneous unexpected deaths in twins.

Fatal Course of Foodborne Botulism in an Eigth-Month Old Infant

“…5 Foodborne cases have also been reported in 1 to 2 year-old infants (2 fatal and 3 non-fatal cases) mostly due to ingestion of home-canned baby food. 5,6 In Italy, infant botulism has been the only form diagnosed in infants, with a total of 32 cases reported from 1984 to July 2011. Our case represents the first foodborne botulism involving an infant under the age of one year in Europe and the youngest fatal botulism case ever reported.…”