Diagnosis

To diagnose botulism, your doctor will check you for signs of muscle weakness or paralysis, such as drooping eyelids and a weak voice. Your doctor will also ask about the foods you've eaten in the past few days, and ask if you may have been exposed to the bacteria through a wound.

In cases of possible infant botulism, the doctor may ask if the child has eaten honey recently and has had constipation or sluggishness.

Analysis of blood, stool or vomit for evidence of the toxin may help confirm an infant or foodborne botulism diagnosis, but because these tests may take days, your doctor's clinical examination is the primary means of diagnosis.

Treatment

For cases of foodborne botulism, doctors sometimes clear out the digestive system by inducing vomiting and giving medications to induce bowel movements. If you have botulism in a wound, a doctor may need to remove infected tissue surgically.

Antitoxin

If you're diagnosed early with foodborne or wound botulism, injected antitoxin reduces the risk of complications. The antitoxin attaches itself to toxin that's still circulating in your bloodstream and keeps it from harming your nerves.

The antitoxin cannot, however, reverse the damage that's been done. Fortunately, nerves do regenerate. Many people recover fully, but it may take months and 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. However, these medications are not advised for other types of botulism because they can hasten the release of the toxins.

Breathing assistance

If you're having trouble breathing, you will probably need a mechanical ventilator for up to several weeks as the effects of the toxin gradually lessen. 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 the disease.

Preparing for your appointment

You may first see your primary care doctor. However, you'll likely be sent to the hospital for immediate treatment. At the hospital, you'll probably also see a doctor who specializes in neurology (neurologist) or infectious diseases.

What you can do

  • Bring any medications you take with you, and let your doctor know about any vitamins or supplements you're taking.
  • Write down questions to ask your doctor. Although you may not have time to write down questions before your first appointment, write down any questions you want to ask at your follow-up appointments.

For botulism, some basic questions to ask your doctor 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 your doctor any other appropriate questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did you begin having symptoms?
  • Have your symptoms been continuous or occasional?
  • Have you or your child eaten any canned food recently?
  • If your infant is ill, has he or she consumed honey?
  • Did anyone else eat the food suspected of making you ill?
June 13, 2015
References
  1. Pegram PS, et al. Botulism. http://www.uptodate.com/home. Accessed May 5, 2015.
  2. Botulism. Centers for Disease Control and Prevention. http://www.cdc.gov/nczved/divisions/dfbmd/diseases/botulism/. Accessed May 7, 2015.
  3. Longo DL, et al.Botulism. In: Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed May 5, 2015.
  4. Goldsmith LA, et al., eds. Botulinum toxin. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed May 11, 2015.
  5. Chalk C, et al. Medical treatment for botulism. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008123.pub3/abstract. Accessed May 11, 2015.
  6. Principles of home canning. National Center for Home Food Preservation. http://nchfp.uga.edu/publications/publications_usda.html. Accessed May 11, 2015.
  7. Rosow LK, et al. Infant botulism: Review and clinical update. Pediatric Neurology 2015;52:487.