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From Botox Party to Botulism: A Case Report and Public Health Warning on Adulterated Botulinum Toxin Injection
Emily F Dawson1, Soniya Pateriya1, Zachary A Blashinsky1
1Internal Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
Cureus
|August 30, 2024
Summary
Botulinum toxin (BoNT) aesthetic injections caused severe paralysis and breathing issues in a patient. Prompt antitoxin treatment led to significant recovery, highlighting risks of unlicensed procedures.
Area of Science:
- Neurology
- Toxicology
- Dermatology
Background:
- Botulinum toxin (BoNT) is widely used in cosmetic and medical procedures.
- Recent increases in botulism toxicity cases linked to aesthetic injections have been reported in the US.
- Unlicensed practitioners performing BoNT injections pose significant health risks.
Observation:
- A patient developed bulbar paralysis and respiratory distress after receiving BoNT injections from an unlicensed aesthetician at home.
- Clinical presentation included ptosis, dysphagia, dysarthria, shortness of breath, and proximal muscle weakness.
- These symptoms are consistent with iatrogenic botulism.
Findings:
- The patient received botulism antitoxin, resulting in marked clinical improvement.
- The exact pathophysiology of iatrogenic botulism is unclear but may involve improper dosing or direct vascular injection.
- Counterfeit BoNT products with unsafe components or excessive toxin levels are a concern.
Implications:
- This case underscores the critical importance of seeking aesthetic treatments only from licensed and qualified professionals.
- Awareness of the potential dangers associated with illicit BoNT injections is crucial for public health.
- Further investigation into the safety of non-medical BoNT administration is warranted.
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