[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-459115-105":59,"doc-detail-459115-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","iatrogenic-botulism-following-cosmetic-botulinum-toxin-injection-presenting-with-respiratory-distress-a-case-report","Iatrogenic Botulism Following Cosmetic Botulinum Toxin Injection Presenting With Respiratory Distress - A Case Report","","Botulinum toxin (BoNT) is widely used in therapeutic and cosmetic care, typically causing localized, transient adverse effects. Systemic complications, especially iatrogenic botulism, are rare but can be life-threatening when the neurotoxin spreads unintentionally. This case report describes a severe presentation in a previously healthy 47-year-old man developing progressive neurological symptoms after cosmetic BoNT injections to the glabellar region, culminating in respiratory muscle involvement and mechanical ventilation. Neurophysiology supported a presynaptic neuromuscular transmission defect. Early recognition enabled timely heptavalent botulinum antitoxin administration and gradual recovery.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/iatrogenic-botulism-following-cosmetic-botulinum-toxin-injection-presenting-with-respiratory-distress-a-case-report/459115/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/iatrogenic-botulism-following-cosmetic-botulinum-toxin-injection-presenting-with-respiratory-distress-a-case-report/459115.png","ImageObject",300,407,{"name":92,"@type":93},"dawugda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What causes iatrogenic botulism after cosmetic botulinum toxin injections?","Question",{"text":112,"@type":113},"It results from unintended systemic spread of the neurotoxin beyond the injection site, producing a potentially life-threatening neuromuscular blockade.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What symptoms did the patient develop after glabellar BoNT injections?",{"text":117,"@type":113},"Within days, he experienced worsening bilateral ptosis, ophthalmoplegia, dysarthria, and dysphagia, with progression to respiratory muscle involvement requiring mechanical ventilation.",{"name":119,"@type":110,"acceptedAnswer":120},"How was treatment handled and why was timing important?",{"text":121,"@type":113},"Prompt clinical recognition supported timely administration of heptavalent botulinum antitoxin, which neutralizes circulating toxin; delayed administration has been associated with worse outcomes and prolonged recovery.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459115,1790790279,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747870947,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Review began 11/19/2025  \nReview ended 12/03/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nZahur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98836  \nOpen Access Case Report  \nIatrogenic Botulism Following Cosmetic Botulinum Toxin Injection Presenting With Respiratory Distress: A Case Report  \nHaider Zahur 1 , Jawad Malik 2 , Laraib Arshad 2  \n1. Intensive Care, University Hospitals of Leicester NHS Trust, Leicester, GBR 2. Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR  \nCorresponding author: Jawad Malik, [mallikjawad@gmail.com](mallikjawad@gmail.com)  \nAbstract  \nBotulinum toxin (BoNT) is extensively used across a wide range of therapeutic and cosmetic applications due to its efficacy in inhibiting neuromuscular transmission and its well-established safety profile. While adverse effects are typically localized and transient, systemic complications-particularly iatrogenic botulism-are rare but potentially life-threatening events. Iatrogenic botulism results from unintended systemic spread of the neurotoxin, which can occur even at doses commonly used for cosmetic purposes. Wereport a rare and severe case of iatrogenic botulism in a previously healthy 47-year-old male who developed progressive neurological symptoms following cosmetic BoNT injections to the glabellar region. Within days of the procedure, the patient experienced worsening bilateral ptosis, ophthalmoplegia, dysarthria, and dysphagia, which progressed to respiratory muscle involvement requiring mechanical ventilation in an intensive care setting. Neurophysiological studies demonstrated findings consistent with a presynaptic neuromuscular transmission defect. The case presented several diagnostic challenges, as the early clinical features mimicked other neuromuscular disorders such as myasthenia gravis or brainstem stroke. Despite this, prompt recognition based on clinical suspicion led to the timely administration of heptavalent botulinum antitoxin, which was followed by gradual neurological improvement. This case underscores the importance of early identification and management of systemic BoNT toxicity, even in the context of routine cosmetic use. It also highlights the critical need for clinician awareness, early referral to specialized care, and a high index of suspicion in patients presenting with acute cranial neuropathies following BoNT administration. This report aims to highlight the potential for severe systemic complications associated with BoNT use and to emphasize the importance of early antitoxin administration.  \nCategories: Neurology, Emergency Medicine, Internal Medicine  \nKeywords: aesthetic medicine, cosmetic injections, iatrogenic botulism, respiratory distress, toxin-induced respiratory failure  \nIntroduction  \nBotulinum toxin (BoNT) is a potent neurotoxin produced by Clostridium botulinum, which acts by cleaving soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins necessary for acetylcholine release at the presynaptic terminals of neuromuscular junctions, ultimately resulting in flaccid paralysis of the affected muscles [1] . Initially recognized for its paralytic effects in botulism, BoNT has since been repurposed for a wide array of clinical applications. Its use has expanded significantly over the past two decades and now encompasses treatment for dystonias, spasticity, chronic migraine, hyperhidrosis, and various urological and gastrointestinal disorders, in addition to its widespread popularity in aesthetic  \nmedicine [1-3].  \nAmong the seven BoNT serotypes (A-G), serotypes A and B are most commonly used in clinical settings, with BoNT-A formulations-such as onabotulinumtoxinA (Botox®), abobotulinumtoxinA (Dysport®), and incobotulinumto","cbCaipGZhmlUVQkm","https://ap.wps.com/l/cbCaipGZhmlUVQkm","pdf",859864,"English","# Abstract\n# Introduction\n# Case Report\n# Management and Outcome\n# Discussion\n# Conclusion","[{\"question\":\"What causes iatrogenic botulism after cosmetic botulinum toxin injections?\",\"answer\":\"It results from unintended systemic spread of the neurotoxin beyond the injection site, producing a potentially life-threatening neuromuscular blockade.\"},{\"question\":\"What symptoms did the patient develop after glabellar BoNT injections?\",\"answer\":\"Within days, he experienced worsening bilateral ptosis, ophthalmoplegia, dysarthria, and dysphagia, with progression to respiratory muscle involvement requiring mechanical ventilation.\"},{\"question\":\"How was treatment handled and why was timing important?\",\"answer\":\"Prompt clinical recognition supported timely administration of heptavalent botulinum antitoxin, which neutralizes circulating toxin; delayed administration has been associated with worse outcomes and prolonged recovery.\"}]","Iatrogenic Botulism Following Cosmetic Botulinum Toxin Injection Presenting With Respiratory Distress - A Case Report | PDF",1790755225,15]