Wound botulism in drug addicts in the United Kingdom

Clostridium novyi has recently been identified as the causative organism re sponsible for the deaths of 35 heroin addicts who had injected themselves i ntramuscularly. We present two heroin addicts who developed C. botulinum in fection following intramuscular or subcutaneous injection of heroin. Like C . novyi, this grows under anaerobic conditions and clinical presentation ma y be similar; however, descending motor or autonomic signs are invariably p resent in botulism. The prognosis is good if the diagnosis is made early an d appropriate treatment commenced.