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Akiko C. Kimura, Jeffrey I. Higa, Robert M. In California, black tar heroin BTH use among injection drug users IDUs has resulted in an increased number of cases of wound botulism due to Clostridium botulinum , tetanus due to Clostridium tetani , and necrotizing soft-tissue infections due to a variety of clostridia. Cultures of wound specimens from 6 case patients yielded Clostridium sordellii. Some of the patients appeared to have the toxic shock syndrome previously reported to be characteristic of toxin-mediated C. The suspected source of this outbreak was contaminated BTH that was injected subcutaneously or intramuscularly 'skin popped'. This outbreak of C. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:. Typically, access is provided across an institutional network to a range of IP addresses. 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Permissions Icon Permissions. Abstract In California, black tar heroin BTH use among injection drug users IDUs has resulted in an increased number of cases of wound botulism due to Clostridium botulinum , tetanus due to Clostridium tetani , and necrotizing soft-tissue infections due to a variety of clostridia. Issue Section:. You do not currently have access to this article. Download all slides. Comments 0. Add comment Close comment form modal. I agree to the terms and conditions. You must accept the terms and conditions. Add comment Cancel. Submit a comment. Comment title. You have entered an invalid code. Submit Cancel. Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email. Sign in Get help with access. Infectious Diseases Society of America members Sign in through society site. Institutional access Sign in through your institution Sign in through your institution. 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