Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013

MacDonald, Emily; Arnesen, Trude Margrete; Brantsaeter, A B; Gerlyng, P; Grepp, M; Hansen, Bjørn Åsheim; Jonsrud, K.; Lundgren, Bernt; Mellegård, Hilde; Møller-Stray, J; Rønning, Karin; Vestrheim, Didrik Frimann; Vold, Line

doi:10.2807/1560-7917.es2013.18.45.20630

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…The importance of these interventions is supported by the observation that as the outbreak continued patient's length of stay in hospital shortened. 9,19 Prompt treatment can lead to good outcomes, as can be seen in this series with patients improving over days and the majority making full recoveries. 2,13,20 It should be noted, however, that botulism can reoccur in the same individual, with no protection offered by previous exposure.…”

Section: Discussionmentioning

confidence: 61%

“…The importance of these interventions is supported by the observation that as the outbreak continued patient’s length of stay in hospital shortened. 9,19…”

Section: Discussionmentioning

confidence: 99%

“…This is the largest outbreak of wound botulism ever recorded in Europe. [9][10][11] Electronic case records of the 25 patients treated within NHS Greater Glasgow and Clyde (NHS GGC) were identified and this subset case series registered with NHS GGC audit authority. The patients were then ordered by date of presentation.…”

Section: Methodsmentioning

confidence: 99%

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Wound botulism, its neurological manifestations, treatment and outcomes: A case series from the Glasgow outbreak, 2015

et al. 2017

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Background and aims We examined the neurological manifestations, treatment and outcomes of a subset of 25 patients within the largest ever outbreak of wound botulism in Europe. Methods and results All 25 cases were intravenous drug users. The most common presenting symptom was dysarthria in 19/25 (76%), followed by dysphagia in 12/25 (48%), blurred vision in 10/25 (40%) and double vision in 8/25 (32%). Microbiological analysis confirmed the diagnosis in nine cases (36%). Duration of admission positively correlated with time to antitoxin, time to wound debridement and female sex. Conclusion As the outbreak continued, hospital stays shortened, reflecting growing awareness of the outbreak and quicker treatment initiation.

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Section: Discussionmentioning

confidence: 61%

“…The importance of these interventions is supported by the observation that as the outbreak continued patient’s length of stay in hospital shortened. 9,19…”

Section: Discussionmentioning

confidence: 99%

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Wound botulism, its neurological manifestations, treatment and outcomes: A case series from the Glasgow outbreak, 2015

et al. 2017

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“…Abscesses are the most frequent type of SSTI. Wound infections with rather unusual germs like Clostridium (C.) botulinum, C. novyi, tetanus or anthrax have been observed in heroin injectors, especially after subcutaneous or intramuscular injection of heroin (“skin popping”) [ 7 ][ 8 ][ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Forefoot Phlegmon – A Complication of Intravenous Heroin-Addiction

Wollina¹,

Lotti²,

Tchernev³

2018

Open Access Maced J Med Sci

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Infections of the skin and soft tissues (SSTI) are clinical entities with variable presentations, causes, and levels of clinical severity. They are frequent in emergency departments. The most common pathogen in the Western World is Staphylococcus aureus. SSTI may provide a hint to underlying pathologies such as diabetes and other states of immune compromise. Here we present a 41-year-old non-diabetic male patient with pain and swelling of the left forefoot but not any recent trauma. Microbiology identified streptococci. The medical history was positive for intravenous heroin abuse. The diagnosis of forefoot phlegm due to drug addition was confirmed. Treatment was realised by a combination of intravenous antibiosis and drainage. Intravenous drug addiction is a significant risk factor for SSTI.

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“…In 2011, infant botulism was reported from a 2-month-old boy from Argentina [4]. In 2013, four cases of wound botulism were reported in Norway and con irmed in people who injected drugs (PWID) caused by BoNT/B [5]. In 2013, infant botulism case was reported in…”

Section: Introductionmentioning

confidence: 99%