Ophthalmologic Manifestations of Botulism Medication

  • Author: Bhupendra Patel, MD, FRCS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 15, 2012
 

Medication Summary

Antitoxin appears to be the only effective medication. Guanethidine has been used and shown to be not effective, despite reports of improvement in accommodative paresis.

In infant botulism, intravenous therapy with botulism immune globulin (BIG), which was approved by the US Food and Drug Administration (FDA) in 2003, is recommended to shorten the duration and to diminish the potential complications.

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Antitoxins

Class Summary

Trivalent (types A, B, and E) equine botulism antitoxin should be used in the presence of food-borne botulism.

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Botulinum antitoxin

 

Intravenous administration of one vial of botulism antitoxin results in serum levels of type A, B, and E antibodies capable of neutralizing serum toxin concentrations in excess of those reported for botulism patients. Circulating antitoxins have a half-life of 5-8 days.

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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, MBBS, FRANZCO, FRACS  Clinical Senior Lecturer, Oculoplastic Surgery, Save Sight Institute, University of Sydney, Australia

Simon F Taylor, MBBS, FRANZCO, FRACS is a member of the following medical societies: Australian Medical Association and Royal Australasian College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

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.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

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.

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.

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.

References

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  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].

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  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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