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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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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 |
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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 |
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