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October 1977

Ocular Involvement in Wound Botulism

Author Affiliations

From the Neuro-Ophthalmology Unit, Wilmer Ophthalmological Institute, and the Department of Neurology, Johns Hopkins Hospital, Baltimore. Reprint requests to Wilmer Institute, Johns Hopkins Hospital, 601 N Broadway, Baltimore, MD 21205 (Dr Miller).

Arch Ophthalmol. 1977;95(10):1788-1789. doi:10.1001/archopht.1977.04450100090008

• 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.

(Arch Ophthalmol 95:1788-1789, 1977)