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Delayed onset post-traumatic wound botulism

Elrayes, Mai; Al Bachari, Sarah; Macdonagh, Ronan; Peel, Alex; Khurshid, Salman; Hamzah, Juiliana; Holzmann, Tim; ... Kobylecki, Christopher; + view all (2024) Delayed onset post-traumatic wound botulism. Practical Neurology 10.1136/pn-2023-004036. (In press). Green open access

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Abstract

A 41-year-old man developed rapidly progressive cranial neuropathies and muscle weakness followed by respiratory failure, requiring ventilation support. On examination, there was marked bilateral ptosis and ophthalmoplegia with bulbar, neck and proximal upper limb weakness. He had a recent open left humeral fracture that eventually required amputation. Despite immunoglobulin therapy, his progressive weakness continued. Multiple investigation results were inconclusive. Eventually, botulinum type A toxin was found positive, by which time the therapeutic window for antitoxin had passed. He continued on supportive management and was treated for concomitant infections and nosocomial illnesses. He was subsequently weaned from respiratory support and has made a good neurological recovery.

Type: Article
Title: Delayed onset post-traumatic wound botulism
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/pn-2023-004036
Publisher version: http://dx.doi.org/10.1136/pn-2023-004036
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10188072
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