Wound Botulism in the Setting of Pregnancy: A Literature Review and Case Report

• Published in: Curēus (Palo Alto, CA) Vol. 14; no. 9
• Main Authors: Ghantarchyan, Henrik, Phan, Alexander T, Hu, Janie, Thaker, Kunal, Dombrovsky, Inessa, Roloff, Kristina, Arabian, Sarkis
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 17-09-2022; Cureus
• Subjects: Botulism; Case reports; Drug overdose; Drug use; Dysarthria; Dysphagia; Dyspnea; Guillain-Barre syndrome; Heroin; Hospitals; Hypoxia; Infectious Disease; Laboratories; Mechanics; Medical diagnosis; Narcotics; Neuromuscular diseases; Neutrophils; Obstetrics/Gynecology; Oxygen saturation; Patients; Pregnancy; Respiratory failure; Substance Use and Addiction; United States > US; California
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.29273

Botulism is a rare neuroparalytic illness caused by Clostridium botulinum that can manifest as a descending flaccid paralysis, progressing from cranial neuropathies to respiratory failure. Wound botulism, constituting a minority of cases, is majorly associated with the injection of black tar heroin (BTH) in the western United States. A patient population of particular concern is pregnant women, who may experience a more severe course due to the physiological changes that occur in pregnancy. Because botulism in pregnancy lacks pathognomic features, physicians should maintain a high clinical suspicion when faced with a pregnant patient with neurological symptoms and a history of BTH use. Here, we report the case of a 25-year-old G3P1A1 female with a history of BTH use who presented with cranial neuropathies and respiratory insufficiency.