title: Wound botulism in drug users: a still underestimated diagnosis.
abstract: Wound botulism is a rare infectious disease that is becoming a frequent complication of parental drug use. Diagnosis is often difficult and based on clinical suspicion. We report the first Italian case of wound botulism due to intramuscular heroin injection in a 48-year-old man with an acute onset of slurred speech and dysphagia. The most considerable finding of electrophysiological study was the reduction in amplitude of compound muscle action potential which should be considered a useful initial electrodiagnostic sign in the clinical context of botulism. Alerting clinicians to botulism is crucial for a rapid diagnosis and appropriate treatment and thus decreasing mortality and complications.
authors.affiliation: Department of Neurosciences, Psychiatry and Anaesthesiology, AOU G. Martino, University of Messina, Messina, Italy. crodolico@unime.it
authors.forename: C
authors.initials: C
authors.lastname: Rodolico
authors.forename: E
authors.initials: E
authors.lastname: Barca
authors.forename: L
authors.initials: L
authors.lastname: Fenicia
authors.forename: F
authors.initials: F
authors.lastname: Anniballi
authors.forename: A U
authors.initials: AU
authors.lastname: Sinardi
authors.forename: P
authors.initials: P
authors.lastname: Girlanda
mesh_terms: D001906:Botulism / Q000175:diagnosis* / Q000635:transmission*; D003014:Clostridium botulinum / Q000472:pathogenicity; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006556:Heroin Dependence / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000293:injuries; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000382:microbiology*