scholarly journals Wound botulism caused by Clostridium subterminale after a heroin injection

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Paris A. Cook ◽  
Aimee Mishler ◽  
Dan Quan ◽  
Ashley Parrish-Garcia
Keyword(s):  
Emergency Department ◽  
Injection Drug Users ◽  
Clostridium Botulinum ◽  
Drug Users ◽  
Toxin Production ◽  
Traumatic Injuries ◽  
Wound Botulism ◽  
Control And Prevention ◽  
Clostridium Subterminale ◽  
Progressive Weakness

Botulism is caused by toxin production from many species of Clostridium, most commonly Clostridium botulinum as well as C. baratii and C. butyricum. Development of wound botulism is associated with injection drug users but has also been described in traumatic injuries with exposure to soil. A patient presented to the emergency department with a complaint of descending, progressive weakness. He recently reported skin popping with heroin injections. Heptavalent botulinum antitoxin was obtained from the Center for Disease Control and Prevention. On hospital day seven, the anaerobic wound cultures resulted with growth of Clostridium subterminale.

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

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.

scholarly journals Wound Botulism Caused by Botulinum Neurotoxin Type A in a Chronic Parenteral Drug Abuser

2020 ◽  
Vol 12 (3) ◽  
pp. 422-427
Author(s):  
Sohun Awsare ◽  
David Chirikian ◽  
Forshing Lui
Keyword(s):  
Drug Abuse ◽  
Clostridium Botulinum ◽  
Botulinum Neurotoxin ◽  
Type A ◽  
Lower Extremity Weakness ◽  
Wound Botulism ◽  
Control And Prevention ◽  
History Of ◽  
Parenteral Drug Abuse ◽  
Parenteral Drug

Botulism is an acute paralytic disease caused by botulinum neurotoxin (BoNT)-mediated inhibition of neurosignaling at the neuromuscular junction. BoNTs are produced by gram positive, anaerobic, spore-forming bacteria from the genus <i>Clostridium,</i>most commonly<i> Clostridium botulinum</i>. Over the last decade, a previously uncommon form of botulism, wound botulism, has increased in prevalence possibly due to the rise in parenteral drug abuse. A 53-year-old patient with a history of drug abuse presents to a rural emergency department with rapidly progressing lower extremity weakness over the past few days. He reports a recent heroin injection into right buttock and diffuse skin-popping scarring was observed throughout. The patient was treated with heptavalent botulinum antitoxin obtained from the Center for Disease Control and Prevention (CDC). A right thigh abscess culture was positive for<i> Clostridium tertium</i>, a left hip abscess culture was positive for methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA), and blood culture confirmed multi-microbial bacteremia caused by <i>Staphylococcus epidermidis</i> and <i>Streptococcus mitis</i>. Serum analysis was positive for BoNT type A from a suspected concurrent<i> Clostridium botulinum</i> infection as <i>C. tertium</i> is not known to produce BoNT type A. This case report highlights the importance of early antitoxin treatment for patients with suspected wound botulism.

scholarly journals Wound Botulism in Injection Drug Users

2007 ◽  
Vol 13 (6) ◽  
pp. 942-943 ◽  
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

scholarly journals Recurrent Wound Botulism Among Injection Drug Users in California

2011 ◽  
Vol 52 (7) ◽  
pp. 862-866 ◽  
Author(s):  
J. Yuan ◽  
G. Inami ◽  
J. Mohle-Boetani ◽  
D. J. Vugia
Keyword(s):  
Injection Drug Users ◽  
Drug Users ◽  
Injection Drug ◽  
Wound Botulism

scholarly journals Cluster of wound botulism cases in injecting drug users in England (*see footnote)

2002 ◽  
Vol 6 (44) ◽  
Author(s):  
P Horby ◽  
A Brown
Keyword(s):  
Clostridium Botulinum ◽  
Drug Users ◽  
Injecting Drug Users ◽  
Microbiology Laboratory ◽  
Republic Of Ireland ◽  
Laboratory Service ◽  
Wound Botulism ◽  
The Public ◽  
The United Kingdom ◽  
The Uk

Six cases of wound botulism in injecting drug users (IDUs) have been reported by the Public Health Laboratory Service Food Safety Microbiology Laboratory (PHLS FSML) in London since 1 August 2002 (1). This brings the total number of clinically diagnosed cases of wound botulism in IDUs reported in the United Kingdom and Republic of Ireland to 13 in 2002 (2, 3). The recent cases may be caused by a batch of drugs contaminated with the anaerobic bacterium Clostridium botulinum. Reports of wound botulism in IDUs are a relatively new phenomenon with no clinically diagnosed cases in the UK and Republic of Ireland up to the end of 1999. There were, however, six reports in 2000 and four in 2001 (4 and references therein, 5 and references therein).

scholarly journals High Rates of Primary Care and Emergency Department Use Among Injection Drug Users in Vancouver

2005 ◽  
Vol 27 (1) ◽  
pp. 62-66 ◽  
Author(s):  
T. Kerr ◽  
E. Wood ◽  
E. Grafstein ◽  
T. Ishida ◽  
K. Shannon ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Injection Drug Users ◽  
Drug Users ◽  
Injection Drug ◽  
Emergency Department Use

scholarly journals Wound botulism presenting as dysphagia to an ENT ward

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.

scholarly journals Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Michael M. Neeki ◽  
Fanlong Dong ◽  
Chuck Emond ◽  
Carol Lee ◽  
Arianna S. Neeki ◽  
...  
Keyword(s):  
Emergency Department ◽  
Drug Users ◽  
Early Recognition ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Heroin Use ◽  
Wound Botulism ◽  
Single Center Experience ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

Abstract Background Clostridium botulinum remains a major threat to a select population of subcutaneous and intramuscular drug users. We conducted a retrospective study of patients who were diagnosed with wound botulism and their clinical presentations to the Emergency Department (ED). Results A total of 21 patients met the inclusion criteria and all had a confirmed history of heroin use disorder. Initial presentation to the ED included generalized weakness (n = 20, 95%), difficulty swallowing (n = 15, 71%), and speech/voice problems (n = 14, 79%). Sixteen patients (76%) also presented with visible skin wounds and fifteen (71%) required mechanical ventilation (MV). Patients who presented with dysphagia as well as dysarthria and/or dysphonia were more likely to require a percutaneous endoscopic gastrostomy (PEG) tube. Patients who required MV and PEG tubes were noted to have a longer hospital length of stay (LOS) due to the severity of the disease progression. Conclusions Emergency physicians should remain vigilant about early recognition of wound botulism, especially in patients who inject drugs.

scholarly journals Heterosexual Risk for HIV Among Black Men in the United States

2011 ◽  
Vol 6 (3) ◽  
pp. 178-181 ◽  
Author(s):  
Anita Raj ◽  
Lisa Bowleg
Keyword(s):  
United States ◽  
Black Men ◽  
Low Income ◽  
Research Program ◽  
Injection Drug Users ◽  
Drug Users ◽  
The United States ◽  
Black Communities ◽  
Control And Prevention ◽  
Sex With Men

Recent data from the Centers for Disease Control and Prevention demonstrate that 1 in 16 Black men in the United States will be infected with HIV in their lifetime. Furthermore, the long-standing HIV disparity in Black communities is actually increasing for Black men. National efforts to curb the epidemic among U.S. Black men focus primarily on men who have sex with men and injection drug users. Black men at heterosexual risk for HIV have largely been neglected by research, program, and policy. This article presents epidemiologic data documenting that heterosexual risk for HIV among Black men is a major concern for Black communities and is likely additional evidence among growing indications of a generalized epidemic in low-income and urban Black communities. The authors offer a call to action to increase support for research, program, and policies that can improve HIV prevention and testing among heterosexual Black men in the United States, as part of the national agenda to reduce rates of HIV in Black communities.

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