伤口肉毒中毒

A 42-year-old man with a history of subcutaneous heroin use presented to the hospital with slurred speech, diplopia, and dysphagia.  The physical examination showed bilateral ptosis , a sluggish pupillary response to light, bilateral sixth-cranial-nerve palsies, and multiple skin abscesses on his arms and legs.  a  clinical diagnosis of wound botulism was made.  Subsequently, Clostridium botulinum was cultured from abscess specimens. Subcutaneous or intramuscular injection of heroin that is contaminated with spores of C. botulinum is a major risk factor for the development of wound botulism