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Awsare S, Chirikian D, Lui F. Wound Botulism Caused by Botulinum Neurotoxin Type A in a Chronic Parenteral Drug Abuser. Case Rep Neurol 2020; 12:422-427. [PMID: 33362521 PMCID: PMC7747075 DOI: 10.1159/000510846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/07/2020] [Indexed: 11/19/2022] Open
Abstract
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.
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Affiliation(s)
- Sohun Awsare
- *Sohun Awsare, California Northstate University College of Medicine, 9700 West Taron Drive, Elk Grove, CA, 95757 (USA),
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Ryabko AK, Kozyr’ AV, Kolesnikov AV, Khlyntseva AE, Zharnikova IV, Shemyakin IG. Strategies for upgrading analyte detection in immuno-PCR studied on identification of type A botulinum neurotoxin. APPL BIOCHEM MICRO+ 2016. [DOI: 10.1134/s0003683816010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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