Bacteriology: wound botulism management: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Microbiology · Bacteriology: wound botulism management

Sample item

A 32-year-old man who injects black-tar heroin under the skin develops diplopia, ptosis, dysarthria and dysphagia, followed by symmetrical descending weakness. He is afebrile, sensation is normal, and there is a small abscess at an injection site. Which management is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Botulinum antitoxin and debridement of the wound

Wound botulism occurs when spores germinate in devitalised tissue, often at skin-popping sites, and the toxin causes descending flaccid paralysis starting with cranial nerves. Treatment is early antitoxin to neutralise circulating toxin, surgical debridement of the source and supportive ventilation if needed.

Option by option

  • A. Human tetanus immunoglobulin with metronidazole

    Tetanus immunoglobulin neutralises tetanospasmin, which causes spastic rigidity, not flaccid paralysis.

  • B. Pyridostigmine after a positive edrophonium test

    Anticholinesterases are used for myasthenia gravis and do not neutralise toxin that has cleaved SNARE proteins.

  • C. Botulinum antitoxin and debridement of the wound (correct)

    Correct. Antitoxin neutralises free toxin and debridement removes the anaerobic focus producing it.

  • D. Intravenous immunoglobulin, as for Guillain-Barre syndrome

    Immunoglobulin treats Guillain-Barre syndrome, which gives ascending weakness with areflexia and does not begin with cranial nerves in an infected wound.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Botulinum antitoxin and debridement of the wound. Wound botulism occurs when spores germinate in devitalised tissue, often at skin-popping sites, and the toxin causes descending flaccid paralysis starting with cranial nerves.

Why is "Human tetanus immunoglobulin with metronidazole" not the answer?

Tetanus immunoglobulin neutralises tetanospasmin, which causes spastic rigidity, not flaccid paralysis.

Why is "Pyridostigmine after a positive edrophonium test" not the answer?

Anticholinesterases are used for myasthenia gravis and do not neutralise toxin that has cleaved SNARE proteins.

Why is "Intravenous immunoglobulin, as for Guillain-Barre syndrome" not the answer?

Immunoglobulin treats Guillain-Barre syndrome, which gives ascending weakness with areflexia and does not begin with cranial nerves in an infected wound.

What concept does this question test?

It tests Bacteriology: wound botulism management in Microbiology. Treatment is early antitoxin to neutralise circulating toxin, surgical debridement of the source and supportive ventilation if needed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bacteriology: wound botulism management?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.