Diagnosis
To diagnose botulism, your health care provider checks you for muscle weakness or paralysis. Your provider looks for symptoms such as drooping eyelids and a weak voice. Your provider asks about foods you've eaten in the past few days. They try to find out if you were exposed to any bacteria through a wound.
In cases of possible infant botulism, the provider may ask if your child has eaten honey recently. The provider may also ask if your infant has constipation or has been less active than usual.
Analysis of blood, stool, or vomit for evidence of the toxin may help confirm a diagnosis of infant or foodborne botulism. But getting these test results may take days. So the provider's exam is the main way to diagnose botulism.
Treatment
For cases of foodborne botulism, health care providers sometimes clear out the digestive system by causing vomiting and giving drugs to help you move your bowels. If you have wound botulism, a provider may need to remove infected tissue in a surgery.
Symptoms related to injections of botulinum toxin for cosmetic or medical reasons usually improve as the toxin is absorbed by the body.
Antitoxin
If you're diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that's moving through your bloodstream and keeps it from harming your nerves.
The antitoxin can't reverse damage that's already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy.
A different type of antitoxin, known as botulism immune globulin, is used to treat infants.
Antibiotics
Antibiotics are recommended for the treatment of wound botulism. These drugs aren't used for other forms of botulism because they can speed up the release of toxins.
Breathing assistance
If you're having trouble breathing, you probably need a mechanical ventilator for up to several weeks while your body fights the toxin's effects. The ventilator forces air into your lungs through a tube inserted in your airway through your nose or mouth.
Rehabilitation
As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by botulism.
Preparing for your appointment
You may start by seeing your primary care health care provider. Or you may be referred immediately to the hospital for treatment. At the hospital, you may likely see several health care providers, including those who specialize in neurology (neurologist) and infectious diseases.
What you can do
When you make the appointment, make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment
- Key personal information, including major stresses, recent life changes and family medical history
- All medications, vitamins, or other supplements you take, including the doses
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you're given.
For botulism, some basic questions to ask your provider include:
- How did I get botulism?
- Will I have any lasting problems?
- What side effects can I expect from treatment?
- Are there dietary restrictions I need to follow?
- How can I prevent this from happening again?
Don't hesitate to ask other questions.
What to expect from your doctor
Your provider is likely to ask you several questions, such as:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- Have you or your child eaten any home-canned food recently?
- If your infant is ill, has your infant eaten honey?
- Did anyone else eat the food suspected of making you ill?