Wound Botulism—An Unusual Cause of Respiratory Failure: A Case Report

Abstract

A man admitted to the hospital 8 days after sustaining a lacerated knee in a motorcycle accident presented with blurred vision, diplopia, dysphonia, and dysphagia—and developed respiratory failure. He was placed on mechanical ventilation and tracheotomized. Wound botulism was suspected and the diagnosis was confirmed by neuromuscular studies. The patient had total cranial and skeletal muscle paralysis, from which he recovered over a 2½ month period. Complications included hemorrhage from the trachea, an ulcerated inominate artery, and two episodes of bilateral pneumonia. Prompt evaluation of respiratory function and provision of respiratory support are essential in managing a patient with wound botulism.