Tseng-Ong Linda, Mitchell Wendy G
Neurology Division, Childrens Hospital Los Angeles, California 90027, USA.
J Child Neurol. 2007 Dec;22(12):1333-7. doi: 10.1177/0883073807308707.
Admissions from January 1, 1985, to December 31, 2005, with the diagnosis of infant botulism were reviewed to describe the clinical presentation, course, outcome, and changes related to the availability of botulism immune globulin treatment. Botulism diagnoses were confirmed by the finding of toxin or Clostridium botulinum organisms in stool samples (type A, 14; type B, 25; type not noted, 5). Twenty-four patients were admitted from 1985-1994 and 20 from 1995-2004. Infants in the two decades were similar in age, demographics, and presenting features. Ventilator support was needed in 13 of 24 (54%) in 1985-1994 and in 15 of 20 (75%) in 1995-2005; 43 required nasogastric feeding. Seventeen patients were treated with botulism immune globulin. Length of stay was shorter in infants treated with botulism immune globulin (13.5 vs 23 days, P = .009), with a trend toward reduced need for nasogastric feeding and in shorter duration of tracheal intubation. All patients recovered fully. Even with the availability of botulism immune globulin, meticulous supportive care remained essential for recovery.
回顾了1985年1月1日至2005年12月31日期间诊断为婴儿肉毒中毒的入院病例，以描述其临床表现、病程、转归以及与肉毒中毒免疫球蛋白治疗可用性相关的变化。通过在粪便样本中发现毒素或肉毒梭菌来确诊肉毒中毒（A型14例；B型25例；未注明类型5例）。1985 - 1994年有24例患者入院，1995 - 2004年有20例。这两个十年中的婴儿在年龄、人口统计学特征和临床表现方面相似。1985 - 1994年的24例中有13例（54%）需要呼吸机支持，1995 - 2005年的20例中有15例（75%）需要；43例需要鼻饲。17例患者接受了肉毒中毒免疫球蛋白治疗。接受肉毒中毒免疫球蛋白治疗的婴儿住院时间较短（13.5天对23天，P = 0.009），鼻饲需求有减少趋势，气管插管持续时间也较短。所有患者均完全康复。即使有了肉毒中毒免疫球蛋白，精心的支持治疗对康复仍然至关重要。
