Botulism

What is botulism?

Botulism is a rare illness that may cause paralysis. Bacteria called Clostridium botulinum or the toxin (poison) they produce gets into your bloodstream and attacks your nerves. Botulism must be treated quickly because it is life-threatening.

What are the main types of botulism?

  • Infant botulism: This is the most common type. It occurs in children who are younger than 1 year. The cause is not always known. Some experts believe it happens after the infant eats dirt, dust, or honey. The bacteria that cause botulism settle in the infant's stomach and begin to grow. The bacteria then begin to poison the infant.

  • Foodborne botulism: You can get this type if you eat food that contains the botulism toxin. Food that is canned at home causes most cases of foodborne botulism. It can develop when meat, fruit, or vegetables are not safely canned.

  • Wound botulism: A sore or cut can become infected with the bacteria if dirt gets into the wound. It can also happen if you inject heroin or other street drugs.

What are the signs and symptoms of infant botulism?

The symptoms can take between 3 and 30 days to develop. You may notice the following in your infant:

  • Constipation

  • Poor ability to suck, or lack of hunger

  • Weak cry

  • More tired or weak than usual

  • Less muscle tone than usual

  • Trouble breathing

What are the signs and symptoms of foodborne and wound botulism?

The symptoms of foodborne botulism usually develop 12 to 36 hours after you eat food that contains the bacteria or toxin. The symptoms of wound botulism develop an average of 7 days after the injury. You may have any of the following:

  • Neurological: These can happen with foodborne and wound botulism.

    • Double vision or blurred vision

    • Eyes that are sensitive to light, or dilated pupils

    • Droopy eyelids

    • Dry mouth or trouble swallowing

    • Muscle weakness in your face, arms, or legs

    • Not able to urinate

  • Intestinal: These occur only with foodborne botulism.

    • Nausea and vomiting

    • Abdominal pain or cramps

    • Diarrhea, sometimes followed by constipation

How is botulism diagnosed?

Your caregiver will ask questions about your symptoms. He will look for and ask about recent injuries or wounds. He will examine your eyes and mouth and check for signs of muscle weakness or paralysis. He will ask for a list of the foods you ate in the past 4 or 5 days. He will want to know if you recently ate any home-canned food. You may also need the following:

  • Vomit or stool tests: Caregivers may test your vomit or bowel movement for the toxin that causes botulism.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your skull and brain. You may be given dye, also called contrast, before the test. Tell the caregiver if you are allergic to dye, iodine, or seafood.

  • Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.

How is botulism treated?

You may need to stay in the hospital for days or weeks to treat botulism. Your symptoms may last 1 month or longer. You may need the following:

  • Antitoxin: This treatment for adults is given to stop paralysis from getting worse. This treatment will not cure paralysis if it has already occurred. It is not used in infants.

  • Immune globulin: This treatment for infant botulism is given to fight the toxin that is in your infant's body. The treatment stays in your infant's body for several months to help him recover. Immune globulin may be used for adults who have an allergy to the antitoxin.

  • Antibiotics: This medicine is given to treat or prevent an infection if you have wound botulism.

  • Surgery: You may need surgery to remove or drain infected skin if you have wound botulism.

What are the risks of botulism?

You may have an allergic reaction to the antitoxin treatment. Botulism may cause paralysis that begins at your head and travels down your body. It can affect your arms, legs, and lungs. You may need a machine called a ventilator if your lungs are paralyzed. This can be life-threatening. The ventilator will help you breathe if you cannot breathe normally on your own.

How can I prevent botulism?

Never give honey to a baby who is younger than 1 year old. Learn proper canning methods if you can food at home. Boil any food that has been canned or vacuum packaged at home. Boil it at 176°F (80°C) for 30 minutes or at 212°F (100°C) for 10 minutes.

What follow-up care will I need after botulism?

You may feel tired or short of breath for several years after your illness. You may need physical therapy to help regain your strength. Ask your caregiver for more information.

When should I contact my caregiver?

Contact your caregiver if:

  • You feel very weak or tired 1 year after your illness.

  • You have questions or concerns about your treatment or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • It is hard for you to take a breath.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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