What are the potential complications of botulism that I should monitor for in affected patients?

Potential complications of botulism to monitor in affected patients include progressive muscle weakness leading to respiratory failure, dysphagia, and autonomic dysfunction. The primary concern is the development of respiratory muscle paralysis, which can necessitate mechanical ventilation and intensive care support ¹. Dysphagia and bulbar muscle weakness are common early complications, increasing the risk of aspiration pneumonia and nutritional compromise. These symptoms require careful monitoring and supportive interventions (Wu et al., 2025). Autonomic disturbances such as dry mouth, blurred vision, and orthostatic hypotension may also occur due to the toxin’s effect on autonomic nerves. Continuous assessment of respiratory function, swallowing ability, and autonomic signs is essential to prevent morbidity and mortality ¹; (Wu et al., 2025).

Additional complications include prolonged neuromuscular weakness and potential secondary infections due to immobility and impaired airway protection. Early recognition and supportive care, including antitoxin administration and respiratory support, are critical to improving outcomes ¹.