{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:31:52Z","timestamp":1757701912359,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,1,26]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>A 44-year-old man with a background of heroin injection drug use was referred to the ear, nose and throat team with a sore throat and dysphagia. He was treated with intravenous antibiotics and steroids for suspected uvulitis. He developed progressive bulbar weakness and symmetrical descending weakness of the upper extremities over a 12-hour period and was intubated prior to transfer to the intensive care unit.<\/jats:p>\n               <jats:p>Botulinum heptavalent antitoxin was administered, and subsequent PCR assay confirmed <jats:italic>Clostridium botulinum<\/jats:italic> neurotoxin B from his most recent injection site. He was found unconscious on the ward 3\u2009days following extubation. Postmortem confirmed he died from heroin intoxication.<\/jats:p>\n               <jats:p>This case highlights the importance of considering wound botulism in injection drug users presenting with unexplained weakness, particularly of the lower cranial nerves. Botulism is not characteristically associated with signs of localised or systemic infection in contrary to other bacterial complications of injection drug use.<\/jats:p>","DOI":"10.1136\/bcr-2019-232367","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T04:15:22Z","timestamp":1581480922000},"page":"e232367","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Wound botulism presenting as dysphagia to an ENT ward"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1572-8470","authenticated-orcid":false,"given":"Lucy Qian","family":"Li","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Cadamy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Seaton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"key":"2025082711543387000_13.2.e232367.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3295"},{"key":"2025082711543387000_13.2.e232367.2","first-page":"iii35","article-title":"Clostridial neurotoxins","volume":"75 Suppl 3","author":"Goonetilleke","year":"2004","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2025082711543387000_13.2.e232367.3","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1177\/0036933017707165","article-title":"Wound botulism, its neurological manifestations, treatment and outcomes: a case series from the Glasgow outbreak, 2015","volume":"62","author":"Martin","year":"2017","journal-title":"Scott Med J"},{"key":"2025082711543387000_13.2.e232367.4","doi-asserted-by":"publisher","DOI":"10.3201\/eid1901.120044"},{"key":"2025082711543387000_13.2.e232367.5","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.05379-0"},{"key":"2025082711543387000_13.2.e232367.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2026.1998.tb00624.x"},{"key":"2025082711543387000_13.2.e232367.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.2.562"},{"key":"2025082711543387000_13.2.e232367.8","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268805003845"},{"key":"2025082711543387000_13.2.e232367.9","first-page":"182","article-title":"Botulism: the challenge of diagnosis and treatment","volume":"3","author":"Brook","year":"2006","journal-title":"Rev Neurol Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:54:45Z","timestamp":1756320885000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,11]]},"published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1136\/bcr-2019-232367"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232367","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}