eMedicine Specialties > Ophthalmology > Infectious Disease

Botulism: Follow-up

Author: Bhupendra Patel, MD, FRCS, Professor of Ophthalmic Plastic and Facial Cosmetic Surgery, Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah School of Medicine
Coauthor(s): Simon F Taylor, MB, BS, FRANZCO, FRACS, Clinical Senior Lecturer, Oculoplastic Surgery, Save Sight Institute, University of Sydney
Contributor Information and Disclosures

Updated: May 11, 2009

Follow-up

Further Inpatient Care

  • Prolonged support, particularly respiratory support, may be required.

Deterrence/Prevention

  • Botulism is a public health emergency.
  • Rapid epidemiologic investigation is critical to prevent further cases if hazardous foodstuffs are still available for consumption.
  • State health departments should be contacted.

Prognosis

  • With early detection and appropriate support, long-term outlook is good. See Mortality/Morbidity for mortality figures.

Patient Education

  • As many US outbreaks of food-borne botulism are due to improperly preserved home-canned foods, provide education about the appropriate cooking time, pressure, and temperature required to destroy spores. Refrigeration of incompletely processed foods is required. Emphasize education about the effectiveness of boiling home-canned vegetables to destroy toxins.
  • For excellent patient education resources, visit eMedicine's Procedures Center. Also, see eMedicine's patient education article BOTOX® Injections.

Miscellaneous

Medicolegal Pitfalls

  • Diagnosis of botulism requires a high index of clinical suspicion.
  • Remember that in wound botulism, the wound may not appear grossly infected.
 


More on Botulism

Overview: Botulism
Differential Diagnoses & Workup: Botulism
Treatment & Medication: Botulism
Follow-up: Botulism
References
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References

  1. Laskawi R. The use of botulinum toxin in head and face medicine: an interdisciplinary field. Head Face Med. Mar 10 2008;4:5. [Medline].

  2. Fach P, Micheau P, Mazuet C, Perelle S, Popoff M. Development of real-time PCR tests for detecting botulinum neurotoxins A, B, E, F producing Clostridium botulinum, Clostridium baratii and Clostridium butyricum. J Appl Microbiol. Mar 9 2009;[Medline].

  3. Hatheway CL. Botulism: the present status of the disease. Curr Top Microbiol Immunol. 1995;195:55-75. [Medline].

  4. Domingo RM, Haller JS, Gruenthal M. Infant botulism: two recent cases and literature review. J Child Neurol. Nov 2008;23(11):1336-46. [Medline].

  5. Mitchell WG, Tseng-Ong L. Reviews of infant botulism at childrens hospital los angeles. J Child Neurol. Aug 2008;23(8):968. [Medline].

  6. Centers for Disease Control and Prevention. Botulism in the United States, 1899-1996. Handbook for epidemiologists, clinicians, and laboratory workers. Atlanta, Ga: 1998:1-43. [Full Text].

  7. Teismann IK, Steinstraeter O, Warnecke T, et al. Cortical recovery of swallowing function in wound botulism. BMC Neurol. May 7 2008;8:13. [Medline].

  8. Domingo RM, Haller JS, Gruenthal M. Infant botulism: two recent cases and literature review. J Child Neurol. Nov 2008;23(11):1336-46. [Medline].

  9. König H, Gassman HB, Jenzer G. Ocular involvement in benign botulism B. Am J Ophthalmol. Sep 1975;80(3 Pt 1):430-2. [Medline].

  10. Albert DM, Jakobiec FA. Systemic bacterial infections and the eye. In: Ryan ET, Sullivan BA, eds. Principles and Practice of Ophthalmology: Clinical Practice. WB Saunders Co; 1994:3006-10.

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Further Reading

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Keywords

botulism, botulinum toxin, BOTOX®, strabismus, blepharospasm, facial dystonia, Clostridium botulinum, C botulinum

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Contributor Information and Disclosures

Author

Bhupendra Patel, MD, FRCS, Professor of Ophthalmic Plastic and Facial Cosmetic Surgery, Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah School of Medicine
Bhupendra Patel, MD, FRCS is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, Royal College of Surgeons of England, and Royal Society of Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Simon F Taylor, MB, BS, FRANZCO, FRACS, Clinical Senior Lecturer, Oculoplastic Surgery, Save Sight Institute, University of Sydney
Simon F Taylor, MB, BS, FRANZCO, FRACS is a member of the following medical societies: Australian Medical Association and Royal Australasian College of Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Andrew W Lawton, MD, Medical Director of Neuro-Ophthalmology Service, Section of Ophthalmology, Baptist Eye Center, Baptist Health Medical Center
Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Brian R Younge, MD, Professor of Ophthalmology, Mayo Clinic School of Medicine
Brian R Younge, MD is a member of the following medical societies: American Medical Association, American Ophthalmological Society, and North American Neuro-Ophthalmology Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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