Wound Botulism in Injection Drug Users

Wiltrud Maria Kalka-Moll; Ute Aurbach; Reiner Schaumann; Rosemarie Schwarz; Harald Seifert

doi:10.3201/eid1306.061336

Wound Botulism in Injection Drug Users

Emerging Infectious Diseases ◽

10.3201/eid1306.061336 ◽

2007 ◽

Vol 13 (6) ◽

pp. 942-943 ◽

Cited By ~ 18

Author(s):

Wiltrud Maria Kalka-Moll ◽

Ute Aurbach ◽

Reiner Schaumann ◽

Rosemarie Schwarz ◽

Harald Seifert

Keyword(s):

Injection Drug Users ◽

Drug Users ◽

Injection Drug ◽

Wound Botulism

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Recurrent Wound Botulism Among Injection Drug Users in California

Clinical Infectious Diseases ◽

10.1093/cid/cir005 ◽

2011 ◽

Vol 52 (7) ◽

pp. 862-866 ◽

Cited By ~ 25

Author(s):

J. Yuan ◽

G. Inami ◽

J. Mohle-Boetani ◽

D. J. Vugia

Keyword(s):

Injection Drug Users ◽

Drug Users ◽

Injection Drug ◽

Wound Botulism

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Wound botulism presenting as dysphagia to an ENT ward

BMJ Case Reports ◽

10.1136/bcr-2019-232367 ◽

2020 ◽

Vol 13 (2) ◽

pp. e232367

Author(s):

Lucy Qian Li ◽

Andrew Cadamy ◽

Andrew Seaton

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

Injection Drug Users ◽

Drug Users ◽

Cranial Nerves ◽

Systemic Infection ◽

Injection Drug ◽

Wound Botulism ◽

Heroin Intoxication ◽

Lower Cranial Nerves

A 44-year-old man with a background of heroin injection drug use was referred to the ear, nose and throat team with a sore throat and dysphagia. He was treated with intravenous antibiotics and steroids for suspected uvulitis. He developed progressive bulbar weakness and symmetrical descending weakness of the upper extremities over a 12-hour period and was intubated prior to transfer to the intensive care unit.Botulinum heptavalent antitoxin was administered, and subsequent PCR assay confirmed Clostridium botulinum neurotoxin B from his most recent injection site. He was found unconscious on the ward 3 days following extubation. Postmortem confirmed he died from heroin intoxication.This case highlights the importance of considering wound botulism in injection drug users presenting with unexplained weakness, particularly of the lower cranial nerves. Botulism is not characteristically associated with signs of localised or systemic infection in contrary to other bacterial complications of injection drug use.

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Wound Botulism in Black Tar Heroin Injecting Users: A Case Series

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211028078 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110280

Author(s):

Nadia Raza ◽

Sandhya Dhital ◽

Valerie Elise Espinoza ◽

Roopam Jariwal ◽

Chien-Wai Chiu ◽

...

Keyword(s):

Cranial Nerve ◽

Injection Drug Users ◽

Clostridium Botulinum ◽

Drug Users ◽

Case Series ◽

Lower Extremities ◽

Upper Extremities ◽

Injection Drug ◽

Wound Botulism ◽

Cranial Nerve Palsies

The incidence of wound botulism in injection drug users has increased since the introduction of black tar heroin. Many species of the Clostridium genus, most commonly Clostridium botulinum, Clostridium baratii, and Clostridium butyricum, have been associated with wound botulism. Patients often present with progressive bulbar weakness, including dysphagia, cranial nerve palsies, and loss of speech, in addition to symmetrical descending weakness of the upper extremities that may progress to the chest and lower extremities. In this article, we present 3 cases of wound botulism, in which the patients presented with bulbar weakness and were treated with botulism antitoxin heptavalent. The time to antitoxin administration and its effect on the patients’ clinical courses is compared.

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