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