Cargando…

Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review

BACKGROUND: Clostridium botulinum remains a major threat to a select population of subcutaneous and intramuscular drug users. We conducted a retrospective study of patients who were diagnosed with wound botulism and their clinical presentations to the Emergency Department (ED). RESULTS: A total of 2...

Descripción completa

Detalles Bibliográficos
Autores principales: Neeki, Michael M., Dong, Fanlong, Emond, Chuck, Lee, Carol, Neeki, Arianna S., Hajjafar, Keeyon, Messinger, Megan, Anderson, Caitlyn O., Hajjafar, Reza, Borger, Rodney
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8456643/
https://www.ncbi.nlm.nih.gov/pubmed/34551726
http://dx.doi.org/10.1186/s12245-021-00375-4
_version_ 1784570910070538240
author Neeki, Michael M.
Dong, Fanlong
Emond, Chuck
Lee, Carol
Neeki, Arianna S.
Hajjafar, Keeyon
Messinger, Megan
Anderson, Caitlyn O.
Hajjafar, Reza
Borger, Rodney
author_facet Neeki, Michael M.
Dong, Fanlong
Emond, Chuck
Lee, Carol
Neeki, Arianna S.
Hajjafar, Keeyon
Messinger, Megan
Anderson, Caitlyn O.
Hajjafar, Reza
Borger, Rodney
author_sort Neeki, Michael M.
collection PubMed
description BACKGROUND: Clostridium botulinum remains a major threat to a select population of subcutaneous and intramuscular drug users. We conducted a retrospective study of patients who were diagnosed with wound botulism and their clinical presentations to the Emergency Department (ED). RESULTS: A total of 21 patients met the inclusion criteria and all had a confirmed history of heroin use disorder. Initial presentation to the ED included generalized weakness (n = 20, 95%), difficulty swallowing (n = 15, 71%), and speech/voice problems (n = 14, 79%). Sixteen patients (76%) also presented with visible skin wounds and fifteen (71%) required mechanical ventilation (MV). Patients who presented with dysphagia as well as dysarthria and/or dysphonia were more likely to require a percutaneous endoscopic gastrostomy (PEG) tube. Patients who required MV and PEG tubes were noted to have a longer hospital length of stay (LOS) due to the severity of the disease progression. CONCLUSIONS: Emergency physicians should remain vigilant about early recognition of wound botulism, especially in patients who inject drugs.
format Online
Article
Text
id pubmed-8456643
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-84566432021-09-22 Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review Neeki, Michael M. Dong, Fanlong Emond, Chuck Lee, Carol Neeki, Arianna S. Hajjafar, Keeyon Messinger, Megan Anderson, Caitlyn O. Hajjafar, Reza Borger, Rodney Int J Emerg Med Original Research BACKGROUND: Clostridium botulinum remains a major threat to a select population of subcutaneous and intramuscular drug users. We conducted a retrospective study of patients who were diagnosed with wound botulism and their clinical presentations to the Emergency Department (ED). RESULTS: A total of 21 patients met the inclusion criteria and all had a confirmed history of heroin use disorder. Initial presentation to the ED included generalized weakness (n = 20, 95%), difficulty swallowing (n = 15, 71%), and speech/voice problems (n = 14, 79%). Sixteen patients (76%) also presented with visible skin wounds and fifteen (71%) required mechanical ventilation (MV). Patients who presented with dysphagia as well as dysarthria and/or dysphonia were more likely to require a percutaneous endoscopic gastrostomy (PEG) tube. Patients who required MV and PEG tubes were noted to have a longer hospital length of stay (LOS) due to the severity of the disease progression. CONCLUSIONS: Emergency physicians should remain vigilant about early recognition of wound botulism, especially in patients who inject drugs. Springer Berlin Heidelberg 2021-09-22 /pmc/articles/PMC8456643/ /pubmed/34551726 http://dx.doi.org/10.1186/s12245-021-00375-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Research
Neeki, Michael M.
Dong, Fanlong
Emond, Chuck
Lee, Carol
Neeki, Arianna S.
Hajjafar, Keeyon
Messinger, Megan
Anderson, Caitlyn O.
Hajjafar, Reza
Borger, Rodney
Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
title Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
title_full Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
title_fullStr Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
title_full_unstemmed Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
title_short Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
title_sort early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8456643/
https://www.ncbi.nlm.nih.gov/pubmed/34551726
http://dx.doi.org/10.1186/s12245-021-00375-4
work_keys_str_mv AT neekimichaelm earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT dongfanlong earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT emondchuck earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT leecarol earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT neekiariannas earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT hajjafarkeeyon earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT messingermegan earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT andersoncaitlyno earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT hajjafarreza earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview
AT borgerrodney earlydiagnosisandcriticalmanagementofwoundbotulismintheemergencydepartmentasinglecenterexperienceandliteraturereview