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Letters | November 4, 1998

Wound Botulism Associated With Black Tar Heroin

B. Zane Horowitz, MD; Emilie Swensen, RN, CSPI; Kathy Marquardt, PharmD, ABAT

JAMA. 1998;280(17):1479-1480. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-17-jbk1104.

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To the Editor.—The 1994-1996 outbreak of WB in California has been linked to skin-popping BTH.¹ We consulted with 7 of these patients, 4 of whom had presentations with unilateral cranial nerve findings, considered atypical of classic WB.

Passaro DJWerner SBMcGee JMac Kenzie WRVugia DJ Wound botulism associated with black tar heroin among injecting drug users. JAMA. 1998;279859- 863

Centers for Disease Control and Prevention, Wound botulism—California, 1995. MMWR Morb Mortal Wkly Rep. 1995;44889- 892

Swedberg JWendel THDeiss F Wound botulism. West J Med. 1987;147335- 338

Rapoport SWatkins PB Descending paralysis resulting from occult wound botulism. Ann Neurol. 1984;16359- 361

Mac Donald KLRutherford GWFreldman SM et al. Botulism and botulism-like illness in chronic drug abusers. Ann Intern Med. 1985;102616- 618

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Horowitz B, Swensen E, Marquardt K. Wound Botulism Associated With Black Tar Heroin. JAMA. 1998;280(17):1479-1480. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-17-jbk1104.

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