{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T23:28:46Z","timestamp":1750116526541},"reference-count":9,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Wound botulism is a rare and potentially fatal infectious disease, often seen in patients who abuse injection drugs. It classically presents with dysfunction of bilateral cranial nerves followed by proximal and distal motor weakness, which can progress to respiratory failure. \n\nCase Report: We report a case of a 31-year-old female who presented to the emergency department for the fifth time with an eight-day history of isolated dysphagia without any other neurologic symptoms. She reported a history of injection drug abuse via \u201cskin popping,\u201d was admitted to the hospital, and ultimately diagnosed with wound botulism.\n\nConclusion: This case exemplifies the diagnostic pitfalls of rare diseases such as wound botulism and provides insight regarding the diagnosis and treatment of this entity. This case also highlights the unique medical and social challenges emergency physicians face while trying to reliably evaluate patients who abuse controlled substances.<\/jats:p>","DOI":"10.5811\/cpcem.2020.9.48664","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T01:11:59Z","timestamp":1605575519000},"page":"613-616","source":"Crossref","is-referenced-by-count":1,"title":["Dysphagia Alone as a Unique Presentation of Wound Botulism in the Emergency Department: A Case Report"],"prefix":"10.5811","volume":"4","author":[{"given":"Ryan","family":"Wyatt","sequence":"first","affiliation":[{"name":"Valleywise Health Medical Center, Department of Emergency Medicine, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eytan","family":"Shtull-Leber","sequence":"additional","affiliation":[{"name":"Valleywise Health Medical Center, Department of Emergency Medicine, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Kelly","sequence":"additional","affiliation":[{"name":"Valleywise Health Medical Center, Department of Emergency Medicine, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2020,10,20]]},"reference":[{"key":"ref0","unstructured":"Centers for Disease Control and Prevention (CDC). Botulism Annual Summary, 2017. 2019. Available at: https:\/\/www.cdc.gov\/botulism\/surv\/2017\/index.html. Accessed March 21, 2020."},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Jackson KA, Mahon BE, Copeland J, et. al. Botulism mortality in the USA, 1975-2009.\u00a0Botulinum J. 2015;3(1):6-17.","DOI":"10.1504\/TBJ.2015.078132"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Martin SJ, Penrice G, Amar C, et al. Wound botulism, its neurological manifestations, treatment and outcomes: a case series from the Glasgow outbreak, 2015.\u00a0Scott Med J. 2017;62(4):136-41.","DOI":"10.1177\/0036933017707165"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Peak CM, Rosen H, Kamali A, et al. Wound botulism outbreak among persons who use black tar heroin \u2014 San Diego County, California, 2017\u20132018.\u00a0Morb Mortal Wkly Rep. 2019;67(5152):1415-8.","DOI":"10.15585\/mmwr.mm675152a3"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Chatham-Stephens K, Fleck-Derderian S, Johnson SD, et al. Clinical features of foodborne and wound botulism: a systematic review of the literature, 1932-2015.\u00a0Clin Infect Dis. 2017;66(suppl_1):S11-6.","DOI":"10.1093\/cid\/cix811"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Sobel J. Botulism.\u00a0Clin Infect Dis. 2005;41(8):1167-73.","DOI":"10.1086\/444507"},{"key":"ref6","unstructured":"Andrus P and Guthrie M. (2016). Acute peripheral neurologic disorders. In: Tintinalli J, Stapczynski S, Ma J, et al. (Eds.),\u00a0Tintinalli\u2019s Emergency Medicine: A Comprehensive Study Guide, 8e (1178-1185). New York, NY: McGraw Hill Education."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Croskerry P. Achieving quality in clinical decision making: cognitive strategies and detection of bias.\u00a0Acad Emerg Med. 2002;9(11):1184-204.","DOI":"10.1197\/aemj.9.11.1184"},{"key":"ref8","unstructured":"Centers for Disease Control and Prevention (CDC). Botulism. 2019. Available at: https:\/\/www.cdc.gov\/botulism. Accessed May 5, 2020."}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T15:21:13Z","timestamp":1605799273000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/4v3737h0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,20]]},"references-count":9,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,11,10]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2020.9.48664","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2020,10,20]]}}}