Bacteriology: infant botulism: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Bacteriology: infant botulism

Sample item

A 5-month-old breastfed infant has had constipation for four days, followed by a weak cry, poor suck, ptosis and symmetrical descending hypotonia. His mother had applied honey to his pacifier. Botulinum toxin is detected in stool. Which management is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Human botulism immune globulin with supportive care and readiness for ventilation

Infant botulism results from ingestion of spores that germinate in the immature infant gut and release toxin, which blocks acetylcholine release. Honey is a recognised source. Treatment is supportive, with human-derived botulism immune globulin, and aminoglycosides must be avoided because they potentiate neuromuscular blockade.

Option by option

  • A. Human botulism immune globulin with supportive care and readiness for ventilation (correct)

    Human immune globulin neutralises circulating toxin and supportive care manages respiratory failure.

  • B. Routine equine antitoxin with penicillin

    Equine antitoxin carries risk of hypersensitivity and is not the preferred product in infants.

  • C. Pyridostigmine to reverse the neuromuscular block

    Anticholinesterases do not help because the block is presynaptic from failed acetylcholine release.

  • D. Gentamicin to eradicate gut Clostridium botulinum

    Aminoglycosides worsen neuromuscular blockade and are avoided in botulism.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is A, Human botulism immune globulin with supportive care and readiness for ventilation. Infant botulism results from ingestion of spores that germinate in the immature infant gut and release toxin, which blocks acetylcholine release.

Why is "Routine equine antitoxin with penicillin" not the answer?

Equine antitoxin carries risk of hypersensitivity and is not the preferred product in infants.

Why is "Pyridostigmine to reverse the neuromuscular block" not the answer?

Anticholinesterases do not help because the block is presynaptic from failed acetylcholine release.

Why is "Gentamicin to eradicate gut Clostridium botulinum" not the answer?

Aminoglycosides worsen neuromuscular blockade and are avoided in botulism.

What concept does this question test?

It tests Bacteriology: infant botulism in Microbiology. Honey is a recognised source. Treatment is supportive, with human-derived botulism immune globulin, and aminoglycosides must be avoided because they potentiate neuromuscular blockade.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bacteriology: infant botulism?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.