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Wound Botulism

Skin Toxin-Mediated Botulism


Presentation

  • We present our observations with a descriptive case series of wound botulism secondary to black tar heroin (BTH) injection.[ncbi.nlm.nih.gov]
Hunting
  • Wound Botulism David is a 34-year-old accountant who loves to hunt. During a recent hunting trip, David accidentally cut his arm pretty badly while he was climbing a tree.[study.com]
Lymphadenopathy
  • The following CT-scan of the pelvic region showed a typical abscess formation in the subcutaneous and also in the adductor muscular region along with typical inguinal and paraaortal lymphadenopathy.[bmcsurg.biomedcentral.com]
Camping
  • Authors’ Affiliations (1) Chirurgische Universitäts- und Poliklinik, BG-Klinikum Bergmannsheil GmbH, Universitätsklinikum der Ruhr-Universität, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany References Dorner MB, Schulz KM, Kull S, Dorner BG.[bmcsurg.biomedcentral.com]
Odynophagia
  • 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]
Progressive Dysphagia
  • Botulism is a rare disease caused by intoxication leading to muscle weakness and rapidly progressive dysphagia. With adequate therapy signs of recovery can be observed within several days.[ncbi.nlm.nih.gov]
Pupillary Abnormality
  • Decreased or absent deep tendon reflexes, pupillary abnormalities, incremental responses to fast repetitive nerve stimulation, and positive serology for Clostridia botulinum toxin A were found, but not in all cases.[ncbi.nlm.nih.gov]
Fracture
  • Although the wound at the fracture site appeared benign, cultures obtained when the wound was opened grew Clostridium botulinum, type B.[ncbi.nlm.nih.gov]
  • CASE REPORT A 34-year-old immunocompetent, white man presented to a local community hospital after a diving accident which resulted in a right heel wound and fracture, as well as a closed fracture of the left os calcis.[journals.lww.com]
  • Wound botulism after traumatic open fracture in Italy. Infez Med. 2015;23(3):280–2. PubMed Google Scholar Copyright[bmcsurg.biomedcentral.com]
Proximal Muscle Weakness
  • During the examination, the most common features noted were: proximal muscle weakness of upper and lower extremities (73%), ophthalmoplegia (53%), ptosis (46%). In patients with documented wound botulism, the pupils were reactive in 46%.[ncbi.nlm.nih.gov]
Neck Pain
  • 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]
Cranial Nerve Involvement
  • RESULTS: Clinical data were available in 11 (92%) of 12 patients; in 7 (58%) of the 12 cases, there was cranial nerve involvement including mydriasis, diplopia, dysarthria, and dysphagia, followed by progressing symmetric and flaccid paralysis of proximal[ncbi.nlm.nih.gov]
Limb Weakness
  • A 30-year-old male drug abuser developed ophthalmoplegia, bulbar paralysis, and limb weakness responsive to edrophonium.[ncbi.nlm.nih.gov]
Absent Deep Tendon Reflex
  • Decreased or absent deep tendon reflexes, pupillary abnormalities, incremental responses to fast repetitive nerve stimulation, and positive serology for Clostridia botulinum toxin A were found, but not in all cases.[ncbi.nlm.nih.gov]

Treatment

  • Treatment, including administration of antitoxin, should be initiated prior to definitive diagnosis by microbiologic laboratory tests.[ncbi.nlm.nih.gov]

Prognosis

  • Accordingly, the prognosis is usually favorable and the bladder recovery complete.[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]
Sex distribution
Age distribution

Pathophysiology

  • A case is reported and the pathophysiology, diagnosis, and treatment are reviewed.[ncbi.nlm.nih.gov]
  • General 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 potent poisons.[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]

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