Cardoso Teresa, Costa Manuela, Almeida H Cristina, Guimarães Mário
Serviços de Medicina Interna, Neurologia, Oftalmologia e Doenças Infecciosas do Hospital Pedro Hispano - Unidade Local de Saúde de Matosinhos.
Acta Med Port. 2004 Jan-Feb;17(1):54-8. Epub 2004 Feb 27.
Food-borne botulism is a disease caused by the ingestion of food contaminated with botulinum toxin, often present in smoked meat, canned food and preserved food; it can occur as sporadic case or as an outbreak. In the last decades there has been an increasing incidence of food-borne botulism in Portugal. The authors do a review of five cases of food-borne botulism, three isolated cases and 2 familiar. Four were associated with the ingestion of smoked ham and one of canned tunafish. The incubation period was 48 hours in one patient and 4 days in another, in the remaining patients it was not possible to determine this period. The clinical picture was dominated in all patients by diplopy, dysphagia, dizziness, blurred vision, dry mouth and constipation, and in two patients there were gastrointestinal complains. In one patient the electromyography findings were compatible with pre-synaptic neuromuscular blockage. A toxin type B was found in the serum of one patient and in the food involved in the two familiar cases. All patients experienced complete recovery with only symptomatic treatment. With this article the authors intend to call attention to this diagnosis, which is not rare, but difficult for someone not familiar with its presentation, being of notice that the diagnosis is essentially clinic with a strong epidemiological history, confirmed by typical electromyography findings and by the identification of the toxin involved. In Portugal there is only descriptions of clinical cases associated with the type B and the type E toxins, not being necessary the resource to the antitoxin therapy.
食源性肉毒中毒是一种因摄入被肉毒杆菌毒素污染的食物而引发的疾病,这种毒素常见于烟熏肉、罐头食品和腌制食品中;它可散发发病或暴发流行。在过去几十年里,葡萄牙食源性肉毒中毒的发病率呈上升趋势。作者回顾了5例食源性肉毒中毒病例,其中3例为散发病例,2例为家庭聚集性病例。4例与食用烟熏火腿有关,1例与食用罐装金枪鱼有关。1例患者的潜伏期为48小时,另1例为4天,其余患者无法确定潜伏期。所有患者的临床表现均以复视、吞咽困难、头晕、视力模糊、口干和便秘为主,2例患者有胃肠道不适症状。1例患者的肌电图检查结果与突触前神经肌肉阻滞相符。在1例患者的血清以及2例家庭聚集性病例所涉食物中发现了B型毒素。所有患者仅通过对症治疗就完全康复。作者撰写本文旨在提醒人们关注这种诊断,它并不罕见,但对于不熟悉其表现的人来说诊断困难,需要注意的是,诊断主要依据临床症状及强有力的流行病学史,并通过典型的肌电图检查结果和所涉毒素的鉴定来确诊。在葡萄牙,仅有与B型和E型毒素相关的临床病例描述,无需使用抗毒素疗法。