A rare differential diagnosis in dysphagia: wound botulism.
The incidence of wound botulism is increasing dramatically among intravenous drug users. Efficient intensive care and early treatment with antitoxin is essential to avoid lethal courses. The clinical picture of botulism is of descending, symmetric, flaccid paralysis. Early symptoms include cranial nerve palsies resulting in blurred vision and diplopia, difficulty in focusing, ptosis, facial weakness, dysphagia, dysphonia, and dysarthria. Because patients presenting with dysarthria and dysphagia will often be seen by an ear, nose and throat specialist initially, this rare but upcoming neurologic disease must be considered in the differential diagnoses.
Preuss
Simon Florian
SF
Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, University of Cologne, Cologne, Germany. simon.pruess@uni-koeln.de
Veelken
Florian
F
Galldiks
Norbert
N
Klussmann
Jens Peter
JP
Neugebauer
Peter
P
Nolden-Hoverath
Silke
S
Huttenbrink
Karl-Bernd
KB
D000328:Adult; D001904:Botulinum Antitoxin / Q000627:therapeutic use; D001906:Botulism / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006556:Heroin Dependence; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D035583:Rare Diseases; D012138:Respiratory Therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014139:Tracheostomy; D016896:Treatment Outcome
D001904:Botulinum Antitoxin