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Table 1 Symptoms at initial ED presentation and diagnostic methods

From: Early diagnosis and critical management of wound botulism in the emergency department: a single center experience and literature review

  Frequency (N = 21) Percentage
Symptoms at initial ED presentation
 History of heroin usage 21 100.0%
 Visible wound 16 76.2%
 Symmetric motor weakness 14 66.7%
 Ptosis 12 57.1%
 Visible abscess 10 47.6%
 Dysarthria 9 42.9%
 Extraocular muscle palsy 8 38.1%
 Surgical wound drainage 7 33.3%
 Descending paralysis 6 28.6%
 Infected abscess 6 28.6%
 Signs of IV or subcutaneous heroin use 5 23.8%
Diagnostic methods
 Blood sample 11 52.40%
 Unclear—antitoxin given 6 28.60%
 CDC consultation—signs and symptoms 4 19.10%
 Unclear 4 19.10%
 EMG study 3 14.30%
  1. *All other responses were either “no” or “not documented” by the physician