Wound Botulism

What is Wound Botulism? Causes & Symptoms

Wound botulism is considered a type of botulism, which is a rare acquired disease that is transmitted through contaminated soil, open wounds, and food. Without treatment, this condition can lead to breathing difficulties, paralysis, and even death. Typically, wound botulism is one of the three types of botulism. The other two are infant and foodborne botulism.

Wound botulism also occurs when you have an open wound and the Clostridium botulinum bacteria gets in it and multiplies, producing toxins. These toxins move through the body and attack the nerves, making it hard for you to breathe and cause muscle weakness.

Recently, heroin users have reported an increasing number of wound botulism cases. This is because it's suspected that heroin contains spores of the bacteria. People who inject black tar heroin have a higher risk of getting this rare condition.

Signs & Symptoms

If you use heroin, you will start noticing the symptoms after several days of use should you get the bacteria. The symptoms don't start immediately. This is because it will take several days or weeks for the bacteria to multiply and produce toxins. Some of the symptoms that you'll have include drooping eyelids, a dry mouth, muscle weakness, a thick-feeling tongue, blurred vision, double vision, difficulty swallowing, and slurred speech.

When the condition worsens, you may develop more symptoms such as difficulty breathing and paralysis. In some cases, you can have wound botulism even if the injection site doesn't appear infected.

Some symptoms, such as weakness, slurred speech, and difficulty breathing, tend to resemble those of opioid overdose. So, it helps to seek medical attention to rule out some of them.

If you or someone you know has botulism symptoms, talk to a doctor as soon as possible as this condition can be life-threatening. The earlier you get anti-toxins the better. Moreover, when you see a doctor, try to be direct and as open as possible about the drugs you have been using over the last several weeks.

How Do Heroin Injections Cause Botulism?

About 20 people are usually diagnosed with wound botulism in the U.S. every year. Most people get it from muscle or skin popping black tar heroin. It's not yet clear how black tar heroin contaminates with the botulism germ. These germs live in the soil, so it's highly likely that it can get into heroin during production or transportation.

You cannot get the germs from another person, meaning it's not contagious. It's important to note that heating heroin won't kill the germ as it takes special conditions for it to die.


When you see a doctor for a diagnosis, you'll get a physical exam that helps to identify the symptoms. The doctor will want to know if you used drugs recently and where you used them. Blood or stool tests may also be performed to check for the presence of toxins. Unfortunately, some of these tests take a while to get results, so doctors rely on clinical observation and examination to make a diagnosis.

Treatment of Wound Botulism

An important point to note here is that this condition doesn't have a treatment. The doctor may need to remove the infected tissue from the wound surgically. You'll also get an injection for anti-toxins to help reduce the risk of possible complications. The anti-toxin works by attaching itself to the toxins that are still in the bloodstream and prevents them from causing harm to the nerves.

Unfortunately, if there's already damage to the nerves, anti-toxins cannot help with that. The good news is that nerves can regenerate, and full recovery is possible with months of treatment and therapy. Your doctor can also prescribe antibiotics to help with treating the wound.

If the condition leads to difficulty breathing, you can use a mechanical ventilator for several weeks while the effects of the toxins ease. This system works by forcing air into your lungs through a tube that is inserted into the airway through the mouth or nose.

Wound botulism is a rare condition that can be fatal if ignored. If you use heroin, you can avoid using it and other street drugs altogether. Or, if you're finding it hard to stop the injections, don't share the needles. Don't ignore any wound that you have, especially when you use heroin.

Last Reviewed:
July 14, 2017
Last Updated:
October 19, 2017