Tetanus: A Rare Complication of Black Tar Heroin Use

Elisa M Pichlinski; Emily Hoff; Lindsey Claire Epperson; Elizabeth Morley; James Dazhe Cao; Joby Thoppil; Steven Field; Prayag Mehta; Daniel Good; Ank E Nijhawan

doi:10.1093/ofid/ofab613

Tetanus: A Rare Complication of Black Tar Heroin Use

Open Forum Infect Dis. 2021 Dec 23;9(3):ofab613. doi: 10.1093/ofid/ofab613. eCollection 2022 Mar.

Authors

Elisa M Pichlinski^{1

2}, Emily Hoff^{1

2}, Lindsey Claire Epperson^{1

3}, Elizabeth Morley⁴, James Dazhe Cao³, Joby Thoppil⁴, Steven Field⁴, Prayag Mehta⁴, Daniel Good^{1

4}, Ank E Nijhawan^{1

5}

Affiliations

¹ Parkland Health and Hospital Systems, Dallas, Texas, USA.
² Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
³ Department of Emergency Medicine, Division of Medical Toxicology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁴ Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁵ Department of Internal Medicine, Division of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Abstract

Tetanus is associated with high morbidity and mortality, although this is rarely encountered in high-income countries. We present a case of tetanus in an unvaccinated patient secondary to black tar heroin use that highlights the importance of considering tetanus in appropriate clinical contexts, harm reduction interventions, and universal tetanus vaccination campaigns.

Keywords: case report; heroin; immunization; substance use; tetanus.