Botulism is a rare but serious paralytic illness caused by a nerve toxin produced by the bacterium Clostridium botulinum present in a wound or abscess. Injecting drugs especially under the skin can introduce Clostridium botulinum and allow it to grow. Left untreated, it can lead to toxin production and progressive muscle paralysis and death. Healthcare providers are advised to consider the possibility of botulism in any patient reporting injecting drugs and presenting with the following signs and/or symptoms caused by the bacterial toxin:
- double vision
- blurred vision
- drooping eyelids
- slurred speech
- difficulty swallowing
- dry mouth
- muscle weakness/descending paralysis
- difficulty breathing/shortness of breath
These are all symptoms of muscle paralysis caused by the bacterial toxin. If untreated, these symptoms may progress to cause paralysis of the respiratory muscles, arms, legs, and torso with subsequent death. Physicians should consider the diagnosis if the patient’s history (i.e., injection drug use) and physical examination suggest botulism. The NMDOH recommends that all clinicians be alert for cases of wound botulism, especially in injection drug users; report any suspect case to the Department of Health 24/7/365 at 505-827-0006 so that antitoxin can be obtained as soon as possible if needed; and warn persons who inject drugs about wound botulism including informing them of the signs and symptoms and the need to seek medical care immediately. For more information about botulism, visit https://www.cdc.gov/botulism/index.html.
