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The patient decompensated and was intubated. Botulism antitoxin was given, and the patient eventually recovered. Prompt decision-making based on clinical suspicion and an informed presumptive diagnosis, administration of botulism antitoxin, and aggressive provision of supportive care can arrest the progression of paralysis and be life-saving. With the rise of opioid use in the United States, leading to a reversion to heroin as a cheaper form of opioids, cases of wound botulism may be on the rise. Clinician attentiveness to obtaining sub
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