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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Black tar heroin (BTH)

3

IX.s Botulism (foodborne-, wound-)

2
Last update : 24/10/2016
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Abused drugs/substances (illicit-, street drugs - IV/inhaled)
5
Heroin (inhaled, insufflated, snorted)
4
Heroin (intravenous)
5
Heroin (oral)
2

Publications

Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013.
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 2013 Nov 07;18;20630 2013 Nov 07
Wound botulism resulting from heroin abuse: can you recognize it?
Journal of emergency nursing 2012 May;38;301-3 2012 May
Images in clinical medicine: Wound botulism.
The New England journal of medicine 2010 Dec 16;363;2444 2010 Dec 16
Wound botulism associated with black tar heroin and lower extremity cellulitis.
The Journal of emergency medicine 2001 May;20;371-5 2001 May
Clinical predictors of respiratory failure and long-term outcome in black tar heroin-associated wound botulism.
Chest 2001 Aug;120;562-6 2001 Aug
Wound botulism associated with black tar heroin among injecting drug users.
JAMA 1998 Mar 18;279;859-63 1998 Mar 18

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