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Wound Botulism

Skin Toxin-Mediated Botulism


  • 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]


  • Treatment, including administration of antitoxin, should be initiated prior to definitive diagnosis by microbiologic laboratory tests.[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]
  • Treatment for wound botulism includes prompt debridement of the wound for eliminating anaerobic conditions, intensive care, and treatment with antitoxin.[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]
  • It is important to get medical care as quickly as possible, because the antitoxin and other treatments work better the earlier they are given.[cdc.gov]


  • 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]


  • 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]


  • 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]
  • ISSN: 0950-2688 EISSN: 1469-4409 URL: /core/journals/epidemiology-and-infection[cambridge.org]
  • 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]
Sex distribution
Age distribution


  • 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]


  • European Centre for Disease Prevention and Control. (2015) Wound botulism in people who inject heroin in Norway and the United Kingdom. Stockholm: ECDC.[drugsandalcohol.ie]
  • Centers for Disease Control and Prevention . 1995 . Wound botulism—California, 1995 . Morb. Mortal. Wkly. Rep. 44 : 889 – 892 . 8. Centers for Disease Control and Prevention . 1998 . Tetanus among injecting-drug users—California, 1997 . Morb.[asmscience.org]
  • The guidelines are produced on behalf of the several organisations and the European Centre for Disease Prevention and Control (ECDC) also contributed to their development.[eurosurveillance.org]
  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.de]
  • Neuromuscular transmission studies in patients with acute craniosomatic paralysis can prevent such oversights.[ncbi.nlm.nih.gov]

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