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Case Reports
. 2017 Oct 26;17(1):103.
doi: 10.1186/s12893-017-0300-4.

Effective and rapid treatment of wound botulism, a case report

M Schulte  1 , U Hamsen  2 , T A Schildhauer  2 , T Ramczykowski  2
Affiliations
Case Reports

Effective and rapid treatment of wound botulism, a case report

M Schulte et al. BMC Surg. .

Abstract

Background: The latest news shows several cases of contaminated heroin that is found in different parts all over Europe. This information can be helpful for the emergency doctors to find the correct diagnosis of wound botulism in patients who are intravenous drug users.

Case presentation: We describe a case of a 40-year-old man who presented to the emergency department in 2016. He suffered from mild dysarthria, diplopia, dysphagia and ptosis since two days. The CT-scan of the cerebrum and the liquor were without any pathological results. We found out that the patient is an intravenous drug user and the clinical examination showed an abscess in the left groin. So we treated him with the suspected diagnosis of wound botulism. In the emergency operation we split the abscess, made a radical debridement and complementary treated him with a high dose of penicillin g and two units of botulism antitoxin. The suspected diagnosis was confirmed a few days later by finding the Toxin B in the abscess and in the patient's serum. In the following days the neurological symptoms decreased and the wound healing was without any complications. The patient left the hospital after nine days; the antibiotic therapy with penicillin g was continued for several days. In a following examination, 14 days after the patient's discharge of the hospital, no further symptoms were found and the abscess was treated successfully without any problems.

Conclusion: Because wound botulism is a very rare disease it can be challenging to the attending physician. This case shows a fast treatment with full recovery of the patient without any further disabilities, which can be used for the future.

Keywords: Abscess; Botulinum; Wound botulism.

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Conflict of interest statement

Ethics approval and consent to participate

The Research Ethics Committee (REC) of the Medical Faculty of the Ruhr-University Bochum has reviewed the submitted documents of the above mentioned Case Report on June 22, 2017.

The REC of the Medicine Faculty of the Ruhr-University Bochum works according to the national legal regulations, the Declaration of Helsinki and the ICH-GCP Directives.

Consent for publication

Written informed consent for publication of clinical details and / or clinical images was obtained from the patient.

Competing interests

The authors declare that there are no competing interests. All authors declare: no support from any organisation for the submitted work; no financial relationship with any organisation that might have an interest in the submitted work; no other relationship or activities that could appear to have influenced the submitted work.

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