Massachusetts health care providers should be on the look out for botulism in people who've gotten Botox injections, with four suspected cases under investigation around the South Shore, health officials said Thursday.

In its clinical advisory, the Massachusetts Department of Public Health didn't share specific details on the four cases under investigation, including whether anyone had died. Botulism is an illness that can be deadly.

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But the four cases under investigation are all tied to cosmetic Botox injections — the procedure involves injecting the toxin, created by bacteria, into the skin to smooth out wrinkles. (It can also be used to treat medical conditions, like migraines.)

Injecting too much of the botuli

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