Diagnosis and Treatment

Diagnosis

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

To make a diagnosis, your doctor will ask 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 diseases have symptoms similar to those of botulism, such as Guillain-Barré syndrome, stroke, myasthenia gravis, and opioid overdose. Your doctor may perform special tests to make a diagnosis. Some of these tests are:

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

If these tests don’t determine what is making you sick, your doctor may order laboratory tests to look for the toxin and the 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

Doctors treat botulism with a drug called an antitoxin. The toxin attacks the body’s nerves, and the antitoxin prevents it from causing any more harm. It 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 and even 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 are able to breathe on your own. The paralysis caused by the toxin will improve slowly. The medical and nursing care you receive in the hospital will help you recover.

If you have wound botulism, your doctor may need to surgically remove the source of the toxin-producing bacteria and give you antibiotics.

Survival and Complications

Botulism can result in death due to respiratory failure. However, because of the development of antitoxin and modern medical care, people with botulism today have a much lower chance of dying than people did in the past. Fifty years ago, for every 100 people with botulism, 50 would die. Now, with antitoxin and proper medical treatment, fewer than 5 of every 100 people with botulism die.

Even with antitoxin and intensive medical and nursing care, some patients die from infections or other problems that are 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.

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