Wound Botulism Complicating a Snake Bite Wound Following Traditional Application of Raw Goat Skin Successfully Treated with Botulinum Antitoxin: A Case Report

Wound botulism is a rare, life-threatening neuroparalytic disease caused by neurotoxins produced by in contaminated wounds. Traditional wound care practices, such as applying animal products, may increase the risk. We report the case of a 35-year-old woman from Afghanistan who presented with progressive descending neurological deficits, including bilateral ptosis, blurred vision, diplopia, nasal speech, dysphagia, and respiratory distress. Symptoms began nine months after a snake bite to the left lower leg that evolved into chronic non-healing calf ulcers. Traditional treatment involved direct application of raw goat skin obtained from a slaughterhouse, likely introducing spores into the wound. Clinical findings supported a diagnosis of wound botulism, although microbiological confirmation was unavailable due to resource limitations. Botulinum antitoxin, procured with delay through the World Health Organization, led to the patient's near-complete recovery.