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Botulism Associated with Clostridium botulinum Sinusitis after Intranasal Cocaine Abuse

David B. Kudrow, MD; Dan A. Henry, MD; David A. Haake, MD; Ginder Marshall, MD; and Glenn E. Mathisen, MD
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Requests for Reprints: David A. Haake, MD, UCLA Department of Medicine, Division of Infectious Diseases, 37-121 CHS, UCLA School of Medicine, Los Angeles, CA 90024.

Current Author Addresses: Dr. Kudrow: Department of Neurology, Harbor UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90509.

Dr. Henry: Department of Medicine, Olive View Medical Center, Sylmar, CA 91342.

Dr. Haake: UCLA Department of Medicine, Division of Infectious Diseases, 37-121 CHS, UCLA School of Medicine, Los Angeles, CA 90024.

Dr. Marshall: 105 South Prairie, Inglewood, CA 90301.

Dr. Mathisen: Department of Medicine, Division of Infectious Diseases, Olive View Medical Center, Sylmar, CA 91342.

Ann Intern Med. 1988;109(12):984-985. doi:10.7326/0003-4819-109-12-984
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This excerpt has been provided in the absence of an abstract.

Wound botulism has been identified as a risk of parenteral cocaine abuse (1-3). We report a case of botulism associated with maxillary sinusitis after intranasal cocaine abuse; Clostridium botulinum was subsequently cultured from the maxillary sinus.

A 25-year-old obese man developed headache, diplopia, and disequilibrium one day before admission, followed by dysphonia, dysarthria, dysphagia, increasing weakness, and ataxia. There was a 7-day history of rhinorrhea and sore throat. He had used intranasal cocaine only twice, most recently 10 days earlier, at which time he used one eighth of a gram of cocaine. The cocaine and all food eaten during the


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