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Wound botulism caused by Clostridium subterminale after a heroin injection

Paris A. Cook, Aimee Mishler, Dan Quan, Ashley Parrish-Garcia
  • Paris A. Cook
    Department of Pharmacy, Maricopa Integrated Health System, University of Arizona, Phoenix, AZ, United States
  • Aimee Mishler
    Department of Pharmacy, Maricopa Integrated Health System, University of Arizona, Phoenix, AZ, United States | aimee.mishler@mihs.org
  • Dan Quan
    Department of Emergency Medicine, Maricopa Integrated Health System, University of Arizona, Phoenix, AZ, United States
  • Ashley Parrish-Garcia
    Department of Emergency Medicine, Maricopa Integrated Health System, University of Arizona, Phoenix, AZ, United States

Abstract

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 (CDC)]. On hospital day seven, the anaerobic wound cultures resulted with growth of Clostridium subterminale.

Keywords

Botulism; wound botulism; antitoxin; Clostridium; Clostridium subterminale.

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Submitted: 2018-02-24 04:17:11
Published: 2018-09-05 11:11:37
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Copyright (c) 2018 Paris Cook, Aimee Mishler, Dan Quan, Ashley Parrish-Garcia

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