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Wound Botulism

Skin Toxin-Mediated Botulism


Presentation

  • Wound botulism should be considered in trauma patients and i.v. drug abusers who present with cranial nerve palsies and descending paresis.[ncbi.nlm.nih.gov]
  • In this case, a woman with a history of injection drug use (IDU) presented with dysphagia, odynophagia, and neck pain. Multiple neck abscesses, too small to drain, were seen on imaging.[ncbi.nlm.nih.gov]
  • We present our observations with a descriptive case series of wound botulism secondary to black tar heroin (BTH) injection.[ncbi.nlm.nih.gov]
  • The clinical presentation was similar in groups with RF and without RF. Of those patients who received antitoxin within 12 h of presentation, 57% required mechanical ventilation compared to 85% of patients receiving the antitoxin after 12 h.[ncbi.nlm.nih.gov]
  • The most common presentations were having a visible wound, speech difficulty, double vision, respiratory difficulty, and trouble swallowing. There were no significant differences in clinical presentation between initial and second episodes.[ncbi.nlm.nih.gov]
Precocious Puberty
  • Puberty 148 XLMRHypotonic Facies Syndrome 27 Pseudohypoparathyroidism 149[books.google.de]

Workup

Staphylococcus Aureus
  • aureus infection, unspecified site A49.02 Methicillin resistant Staphylococcus aureus infection, unspecified site A49.1 Streptococcal infection, unspecified site A49.2 Hemophilus influenzae infection, unspecified site A49.3 Mycoplasma infection, unspecified[icd10data.com]
  • Community-acquired methicillin resistant Staphylococcus aureus pyomyositis in an intravenous drug user . Journal of Medical Microbiology 2006 ; 55 : 123 – 125 . 30. Gutzwiller , FS , et al.[cambridge.org]

Treatment

  • Treatment, including administration of antitoxin, should be initiated prior to definitive diagnosis by microbiologic laboratory tests.[ncbi.nlm.nih.gov]
  • Treatment for wound botulism includes prompt debridement of the wound for eliminating anaerobic conditions, intensive care, and treatment with antitoxin.[ncbi.nlm.nih.gov]
  • Conclusion As the outbreak continued, hospital stays shortened, reflecting growing awareness of the outbreak and quicker treatment initiation.[ncbi.nlm.nih.gov]
  • Medical records where reviewed to obtain demographic information, clinical presentation, treatment, and outcome. We identified fifteen patients with mean age of 47 years: twelve men, and three women.[ncbi.nlm.nih.gov]
  • Symptoms resolved after treatment with antitoxin and antibiotics, and hardware excision was deferred. Subsequent osteomyelitis necessitated hardware exchange, and wound cultures grew Clostridium argentinense.[ncbi.nlm.nih.gov]

Prognosis

  • Accordingly, the prognosis is usually favorable and the bladder recovery complete.[ncbi.nlm.nih.gov]
  • Prognosis was favorable, though recovery was slow. In conclusion, acute bulbar weakness with visual symptoms in patients with subcutaneous heroin abuse strongly suggets the possibility of wound botulism.[ncbi.nlm.nih.gov]
  • The patient’s respiratory vital capacity is closely monitored and a ventilation machine is provided for breathing support, if required Prognosis Botulism tends to occur in small outbreaks.[news-medical.net]
  • Prognosis Although botulism can cause severe and prolonged symptoms, most people recover completely from the illness. Early treatment reduces the risk of permanent disability and death. However, even with treatment botulism can be fatal.[drugs.com]

Etiology

  • Applicable To Non-foodborne botulism NOS Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • Foodborne botulism accounted for 2 illnesses, or 1 percent of all cases, with 1 death, infant botulism for 135 illnesses, or 88 percent of all cases, wound botulism for 14 illnesses, or 9 percent of all cases, and botulism of unknown or other etiology[foodsafetynews.com]

Epidemiology

  • The neurological signs and symptoms are the same for all three epidemiological types and may include respiratory paralysis.[ncbi.nlm.nih.gov]
  • All published cases of wound botulism were reviewed to describe the epidemiology, clinical manifestations, diagnosis, and treatment of this rare infection.[ncbi.nlm.nih.gov]
  • The incidence of wound botulism is increasing and the epidemiology of the disease is changing. The majority of new cases are associated with injection drug use, in particular, the use of Mexican black tar heroin.[ncbi.nlm.nih.gov]
  • All patients were injecting drug users (IDU) and the epidemiological investigations suggested contaminated injection drugs as the most probable source of infection.[ncbi.nlm.nih.gov]
  • We reviewed the clinical, epidemiologic, and laboratory features of WB. From the first case in 1951, through 1998, a total of 127 cases were identified-93 in the last 5 years.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • A case is reported and the pathophysiology, diagnosis, and treatment are reviewed.[ncbi.nlm.nih.gov]
  • General Pathogen Clostridium botulinum Pathophysiology Botulinum toxin Irreversibly inhibits acetylcholine release from the motor end plates by interfering in the fusion of transmitter-containing vesicles with the presynaptic membrane One of the most[amboss.com]
  • Pathophysiology The anaerobic bacteria, Clostridium botulinum , produces all seven serotypes of the botulinum neurotoxin (A through G). There are other Clostridium species that produce some of the toxin types as well.[calpoison.org]
  • The pathophysiology of the changes in the gastrointestinal flora that facilitate colonization is unclear. [ 5 ] Iatrogenic botulism due to accidental overdose of botulinum toxin (Botox) Cases of botulism due to Botox overdosage have been reported.[emedicine.medscape.com]

Prevention

  • Neuromuscular transmission studies in patients with acute craniosomatic paralysis can prevent such oversights.[ncbi.nlm.nih.gov]
  • We reviewed the literature and reports to the Centers for Disease Control and Prevention (Atlanta) of laboratory-confirmed cases of wound botulism. From 1943 through 1990, 47 cases were reported.[ncbi.nlm.nih.gov]
  • A greater awareness of this disease is needed by physicians and a close cooperation between public health authorities, street workers, operators of sheltered injecting facilities, and medical centres focusing on IDU is essential to prevent and manage[ncbi.nlm.nih.gov]
  • Early treatment with equine ABE botulinum antitoxin obtained from the Centers for Disease Control and Prevention often shortens the time on a ventilator.[ncbi.nlm.nih.gov]
  • Since 1990, wound botulism associated with injection drug use emerged as the leading cause of wound botulism in the United States; 210 of 217 cases reported to the Centers for Disease Control and Prevention between 1990 and 2002 were associated with drug[ncbi.nlm.nih.gov]

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