Wound botulism caused by Clostridium subterminale after a heroin injection.

Botulism is caused by toxin production from many species of Clostridium , most commonly Clostridium botulinum as well as C. baratii and C. butyricum . Development of wound botulism is associated with injection drug users but has also been described in traumatic injuries with exposure to soil. A patient presented to the emergency department with a complaint of descending, progressive weakness. He recently reported skin popping with heroin injections. Heptavalent botulinum antitoxin was obtained from the [Center for Disease Control and Prevention (CDC)]. On hospital day seven, the anaerobic wound cultures resulted with growth of Clostridium subterminale .