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.