Sir.—Since the first reports of infant botulism from the United States in 1976,1,2 cases have been identified on three additional continents—Australia,3,4 Europe,5,6 and South America.7 We now present the first laboratory-confirmed case of infant botulism to be recognized in Asia.
Patient Report.—A male infant weighed 3200 g at birth on March 4, 1986, after a full-term, uncomplicated pregnancy. He was half breast-fed and half formula-fed, and developed normally. From May 1, honey added to homemade apple juice was occasionally fed to him until the time he was hospitalized. He became constipated on May 5, and an enema was given thereafter every four to five days. On May 25, he was brought to the emergency room because of difficulty swallowing, irritability, and lethargy, and was admitted. He was tachycardic and afebrile. He appeared drowsy and had a weak, constant cry. He showed generalized hypotonicity and diminished