Vossen Matthias Gerhard, Gattringer Klaus-Bernhard, Wenisch Judith, Khalifeh Neda, Koreny Maria, Spertini Verena, Allerberger Franz, Graninger Wolfgang, Kornschober Christian, Lagler Heimo, Reitner Andreas, Sycha Thomas, Thalhammer Florian
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
Case Rep Infect Dis. 2012;2012:438989. doi: 10.1155/2012/438989. Epub 2012 Jun 21.
We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known.
We review the available literature, the compiled clinical data, and observations.
After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases.
Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production.
我们描述了两例肉毒杆菌毒素中毒的相关病例，以便临床医生更好地了解肉毒中毒病例可能的表现形式，因为早期诊断和治疗对肉毒中毒至关重要。肉毒杆菌毒素是已知最强的神经毒素。
我们回顾了现有文献、汇总的临床数据及观察结果。
临床症状缓慢出现后，居住在维也纳的一对已婚夫妇出现吞咽困难、调节功能障碍、无汗、大小便潴留、头晕和恶心。他们感染了B型肉毒杆菌毒素。肉毒中毒在奥地利是一种罕见疾病。在过去21年里，仅报告了12例病例。
两名患者在被送至我们门诊部并得到正确诊断之前，曾去看过全科医生以及几位专科医生。为避免中毒与诊断之间出现长时间延误，我们认为关键是要注意到轻度肉毒杆菌毒素中毒可能产生的复杂症状，特别是由于工业化社会中工业食品生产质量高，中毒情况已很少见。
