Multiple Sclerosis Presenting as a Delirium: A Case Report.

Objective: To report a case of multiple sclerosis (MS) with delirium as the first presentation.

Clinical Presentation And Intervention: A 34-year-old female was referred to our department with an acute onset of drowsiness, withdrawal from routine activities and aggression, followed by neurologic deficits after a couple of days. Clinical and radiographic examinations were performed, leading to the initial diagnosis of MS.

Rapid geographical clustering of wound botulism in Germany after subcutaneous and intramuscular injection of heroin.

Background: Wound infections due to Clostridium botulinum in Germany are rare and occur predominantly in heroin injectors, especially after subcutaneous or intramuscular injection of heroin ("skin popping"), which is contaminated with spores of C. botulinum. We report a rapid geographical clustering of cases in Germany in a region between Cologne, Bonn, and Aachen with wound botulism and consecutive systemic C.

A rare differential diagnosis in dysphagia: wound botulism.

The incidence of wound botulism is increasing dramatically among intravenous drug users. Efficient intensive care and early treatment with antitoxin is essential to avoid lethal courses. The clinical picture of botulism is of descending, symmetric, flaccid paralysis.