Author: Don Stader, M.D.

Educational Pearls

• Wound botulism should be considered in patients with cutaneous lesions and neuromuscular weakness.

• The toxin produced by clostridium botulinum is the causative agent. It forms spores, so it is very resistant to killing by heat.

• It presents with weakness, most often in the extraocular muscles.

• Treatment includes wound care and respiratory support. Anti-toxin is rarely used as it is stored at the CDC and must be flown in.

References: Kalka-Moll WM, Aurbach U, Schaumann R, Schwarz R, Seifert H. Wound Botulism in Injection Drug Users. Emerging Infectious Diseases. 2007;13(6):942-943. doi:10.3201/eid1306.061336.