Diagnosis and Treatment

Diagnosis

Infant botulism is the most common kind of botulism in the United States. Learn about the diagnosis and treatment of this disease on the California Department of Public Health’s Infant Botulism and Treatment Prevention Programexternal icon website.

If you or someone you know has symptoms of botulism, immediately see your doctor or go to the emergency room.

Your doctor will ask you questions and examine you to find out the cause of your symptoms. However, these clues are usually not enough for your doctor to diagnose you because some botulism symptoms also occur with other diseases – such as Guillain-Barré syndrome, meningitis, myasthenia gravis, and stroke – and even opioid overdose.

Your doctor may need to order tests to make a diagnosis. Some of these tests are:

  • Brain scan
  • Spinal fluid examination
  • Nerve and muscle function tests (nerve conduction study and electromyography)
  • Tensilon test for myasthenia gravis

If these tests don’t show what is making you sick, your doctor might order laboratory tests to look for the toxin or bacteria that cause botulism. These laboratory tests are the only way to know for certain whether you have botulism. It may take several days to get the results of your tests from the laboratory. If your doctor suspects you have botulism, you may start treatment right away.

Treatment

Botulism is caused by a toxin that attacks the body’s nerves and causes difficulty breathing, muscle paralysis, and even death.

Doctors treat botulism with a drug called an antitoxin, which prevents the toxin from causing any more harm. Antitoxin does not heal the damage the toxin has already done. Depending on how severe your symptoms are, you may need to stay in the hospital for weeks or even months before you are well enough to go home.

If your disease is severe, you may have breathing problems. You may even have respiratory (breathing) failure if the toxin paralyzes the muscles involved in breathing. If that happens, your doctor may put you on a breathing machine (ventilator) until you can breathe on your own. The paralysis caused by the toxin usually improves slowly. The medical and nursing care you receive in the hospital is to help you recover.

People with wound botulism sometimes need surgery to remove the source of the bacteria and may need to take antibiotics.

Survival and Complications

The development of antitoxin and modern medical care means that people with botulism have a much lower chance of dying than in the past, when about 50 in every 100 people with botulism died. Today, fewer than 5 of every 100 people with botulism die.

Even with antitoxin and intensive medical and nursing care, some people with botulism die from respiratory failure. Others die from infections or other problems caused by being paralyzed for weeks or months.

Patients who survive botulism may have fatigue and shortness of breath for years afterward and may need long-term therapy to help them recover.

Interested in learning more? See CDC’s information for healthcare providers.

Next: Find out how you can prevent botulism >