Wound Botulism in a Patient with a Tooth Abscess: Case Report and Review

Abstract

We describe a case of wound botulism associated with a tooth abscess in a 5-year-old boy. We reviewed the literature and reports to the Centers for Disease Control and Prevention (Atlanta) of laboratory-confirmed cases of wound botulism. From 1943 through 1990, 47 cases were reported. Type A botulinus toxin was identified in 32 cases, type B in 13, types A and B in 1, and an unknown type in 1. Botulism was associated with wounds from trauma, use of injectable drugs, and surgery. Sinusitis after use of intranasal cocaine has also been associated with botulism. Treatment for wound botulism includes prompt debridement of the wound for eliminating anaerobic conditions, intensive care, and treatment with antitoxin.

Botulismo por herida traumática

“…Se decidió, por el curso clínico de la niña, no realizar tratamiento específico con antitoxina, y la evolución ha sido favorable. 9 n BiBliogRAFíA…”

Wound Botulism Acquired in the Amazonian Rain Forest of Ecuador

“…In 1993, Weber and others reviewed all 47 cases of laboratory-confirmed wound botulism reported to CDC between 1951 and 1990. 5 Cases were still mostly young (median age ‫ס‬ 27 years) males. A geographic pattern emerged; type A toxin caused disease in 30 (86%) patients from states west of the Mississippi River, whereas type B did in 8 of 10 of patients from eastern states.…”

“…Hispanics have been involved disproportionately and women increasingly so. 5,7 Cases outside the United States have been reported most frequently from the United Kingdom and occasionally elsewhere in Europe and in Australia. [11][12][13][14][15][16][17]25 And what of the less-developed world?…”

“…4 Through 1990, only 47 laboratory-confirmed cases of wound botulism were reported in the United States. 5 Most occurred in young men and were related to trauma. The wounds usually were deep and contained avascular areas, and often were associated with compound fractures or crush injuries.…”

“…The wounds usually were deep and contained avascular areas, and often were associated with compound fractures or crush injuries. 5 Since 1990, the number of wound botulism cases reported in the United States has increased dramatically; almost all have been associated with injection of black tar heroin in residents of California. 6,7 A few cases have been reported in association with paranasal sinus infections from cocaine sniffing.…”