Iatrogenic Botulism Following Unregulated Cosmetic Botulinum Toxin Injection

We report the case of a 35-year-old woman who developed progressive neuromuscular weakness, bulbar symptoms, and dysphagia following administration of unlicensed cosmetic botulinum toxin at home by a non-medical acquaintance. Her husband, who received injections from the same vial, was admitted to intensive care and required intubation. Our patient required close airway monitoring, antitoxin therapy, immunoglobulins, and multidisciplinary support, but did not require ventilatory support. She gradually improved and was discharged with ongoing outpatient neurology and speech therapy follow-up. This case highlights the dangers of unregulated access to botulinum toxin, the importance of early recognition of iatrogenic botulism, and the role of public health reporting in preventing further harm.