Zanon P, Pattis P, Pittscheider W, Roscia G, De Giorgi G, Sacco G, Vötter K, Stockner I, De Giorgi F, Wiedermann C J
Department of Anesthesiology and Critical Care Medicine II, Central Hospital of Bolzano, Italy.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2006 Mar;41(3):156-9. doi: 10.1055/s-2006-924967.
Botulism is a rare but potentially fatal disease caused by toxins produced by Clostridium botulinum. We report botulism in two adult females, one of them just tasting from "bad" asparagus and the other eating the full portion. Both patients survived after intermittent mechanical ventilation and trivalent antitoxin administration. The diagnosis was confirmed by detection of botulinum toxin. Acute onset of bilateral cranial neuropathies associated with symmetric descending weakness as well as some key features of the botulism syndrome including absence of fever, symmetric neurologic deficits, the patients remaining responsive and no sensory deficits, with the exception of blurred vision, led to the clinical diagnosis in the first presenting case which was then easily made in the second. Despite the fact that amount of toxin ingested, time-to-symptom development, and time-to-recovery markedly differed in the two patients, their maximal disease severity was similar.
肉毒中毒是一种由肉毒杆菌产生的毒素引起的罕见但可能致命的疾病。我们报告了两名成年女性的肉毒中毒病例，其中一人只是尝了一点“变质”的芦笋，另一人则吃了完整的一份。两名患者在间歇性机械通气和给予三价抗毒素后均存活。通过检测肉毒杆菌毒素确诊。双侧颅神经病变急性发作，伴有对称性下行性肌无力，以及肉毒中毒综合征的一些关键特征，包括无发热、对称性神经功能缺损、患者仍有反应且无感觉缺损（除视力模糊外），导致了首例病例的临床诊断，随后第二例病例也很容易确诊。尽管两名患者摄入的毒素量、出现症状的时间和恢复时间明显不同，但他们疾病的最大严重程度相似。
