Ocular involvement in wound botulism
N. R. Miller and H. Moses
A 7-year-old girl developed bilateral ptosis, total ophthalmoplegia, and
fixed, dilated pupils associated with bulbar paralysis and generalized
weakness six days after she sustained a compound supracondylar fracture of
the right humerus. Nerve conduction studies showed a facilitated muscle
action potential after repetitive nerve stimulation. Blood cultures were
negative. Although the wound site appeared noninfected, the wound was
explored. Clostridium botulinum, type B, grew from cultures taken from the
depths of the wound. The patient recovered fully with supportive care, and
EEG abnormalities present during the acute phase of the illness
disappeared.