König Kai, Ringe Hannelore, Dorner Brigitte G, Diers Alexander, Uhlenberg Birgit, Müller Dominik, Varnholt Verena, Gaedicke Gerhard
Children's Hospital, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Pediatrics. 2007 Nov;120(5):e1355-8. doi: 10.1542/peds.2006-3386.
We report the uncommon clinical course of tetanus in a completely immunized 14-year-old boy. His initial symptoms, which included a flaccid paralysis, supported a diagnosis of botulism. Preliminary mouse-test results with combined botulinum antitoxins A, B, and E, obtained from tetanus-immunized horses, backed this diagnosis. The change in his clinical course from paralysis to rigor and the negative, more specific, botulinum mouse test with isolated botulinum antitoxins A, B, and E, obtained from nonvaccinated rabbits, disproved the diagnosis of botulism. Tetanus was suspected despite complete vaccination. The final results of a positive mouse test performed with isolated tetanus antitoxin confirmed the diagnosis. Adequate treatment was begun, and the boy recovered completely.
我们报告了一名14岁完全免疫的男孩破伤风不常见的临床病程。他最初的症状包括弛缓性麻痹，这支持肉毒中毒的诊断。从破伤风免疫的马匹中获得的肉毒杆菌抗毒素A、B和E联合进行的初步小鼠试验结果支持了这一诊断。他的临床病程从麻痹转变为强直，以及使用从未接种疫苗的兔子中获得的分离肉毒杆菌抗毒素A、B和E进行的阴性、更具特异性的肉毒杆菌小鼠试验，否定了肉毒中毒的诊断。尽管已完全接种疫苗，但仍怀疑是破伤风。使用分离的破伤风抗毒素进行的阳性小鼠试验的最终结果证实了诊断。开始了适当的治疗，男孩完全康复。
