Tetanus in an injecting buprenorphine abuser.

INTRODUCTION Injecting drug abusers are vulnerable to many infectious complications. We describe a case of tetanus in a Singaporean who regularly abused buprenorphine. CLINICAL PICTURE A 49-year-old male was hospitalised for progressive generalised spasms associated with dysarthria and opisthotonus. Tetanus was diagnosed clinically. TREATMENT Supportive management was instituted in the intensive care unit (ICU). Toxicology samples tested positive for buprenorphine. OUTCOME He recovered rapidly and was transferred out of the ICU after 8 days. Retrospective questioning confirmed parenteral abuse of buprenorphine. CONCLUSION This case highlights an uncommon and potentially lethal complication of parenteral drug abuse.