Fox Christine K, Keet Corinne A, Strober Jonathan B
Division of Child Neurology, UCSF School of Medicine, University of California-San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143-0136, USA.
Pediatr Neurol. 2005 Mar;32(3):149-54. doi: 10.1016/j.pediatrneurol.2004.10.001.
Since infant botulism was first identified three decades ago, our understanding of botulinum toxins and the organisms that produce them has grown. A newer classification system now recognizes Clostridium baratii and Clostridium butyricum along with Clostridium botulinum as causative agents. Recently, increasing therapeutic use of botulinum toxins has sparked substantial new research into their mechanisms of action. This research, and some case reports from infants sickened by unusual botulinum toxins suggest that disease caused by different toxin types may result in varying clinical presentations. Perhaps most significantly for pediatricians and child neurologists, a specific treatment for infant botulism has just been approved. This article reviews the clinical presentation, diagnosis, and treatment of infant botulism, including human botulism immune globulin, and discusses the various organisms and toxins that cause this disease.
自三十年前首次发现婴儿肉毒中毒以来，我们对肉毒杆菌毒素及其产生菌的认识不断加深。一种新的分类系统现在将巴氏梭菌、丁酸梭菌与肉毒梭菌一同视为病原体。最近，肉毒杆菌毒素在治疗方面的应用日益增加，引发了对其作用机制的大量新研究。这项研究以及一些由异常肉毒杆菌毒素致病婴儿的病例报告表明，不同毒素类型所致疾病可能导致不同的临床表现。或许对儿科医生和儿童神经科医生而言最重要的是，一种针对婴儿肉毒中毒的特效治疗方法刚刚获批。本文回顾了婴儿肉毒中毒的临床表现、诊断和治疗，包括人肉毒中毒免疫球蛋白，并讨论了引发该疾病的各种病原体和毒素。
