Transient paralysis of the bladder due to wound botulism

In the last 10 years, wound botulism has increasingly been reported and nea rly all of these new cases have occurred in injecting-drug abusers. After a bsorption into the bloodstream, botulinum toxin binds irreversibly to the p resynaptic nerve endings, where it inhibits the release of acetylcholine. D iplopia, blurred vision, dysarthria, dysphagia, respiratory failure and par esis of the limbs are common symptoms of this intoxication. Surprisingly an d despite the well-known blocking action of the botulinum toxin on the auto nomic nerve system, little attention has been paid to changes in the lower urinary tract following acute botulinum toxin poisoning. Here we report a c ase of bladder paralysis following wound botulism. Early diagnosis and adeq uate management of bladder paralysis following botulism is mandatory to avo id urologic complications. Accordingly, the prognosis is usually favorable and the bladder recovery complete. Copyright (C) 2000 S. Karger AG, Basel.