Sonnabend W F, Sonnabend O A, Gründler P, Ketz E
Lancet. 1987 Feb 14;1(8529):357-61. doi: 10.1016/s0140-6736(87)91729-6.
A 27-year-old man with type F botulism (classification undetermined) had two episodes of botulinum toxaemia with identification of botulinum toxin and Clostridium botulinum organisms in faecal specimens during a three-month stay in hospital. Between these clinical episodes neither toxin nor Cl botulinum could be demonstrated. The illness was severe with quadriplegia, respiratory insufficiency, and bowel paralysis. In addition the patient had sensory abnormalities and a raised protein in the cerebrospinal fluid. The results demonstrate for the first time in detail an intestinal colonisation with and multiplication of C botulinum organisms and in-vivo production of toxin in an adult. The clinical findings at first pointed to Guillain-Barré syndrome, and it is suggested that patients with this syndrome should be examined for botulinum toxin in serum and for toxin and organisms in stool.
一名27岁的F型肉毒中毒患者（分类未确定）在住院三个月期间发生了两次肉毒中毒血症，粪便标本中鉴定出肉毒毒素和肉毒梭菌。在这两次临床发作之间，未检测到毒素或肉毒梭菌。病情严重，出现四肢瘫痪、呼吸功能不全和肠道麻痹。此外，患者有感觉异常，脑脊液蛋白升高。这些结果首次详细证明了肉毒梭菌在成人肠道内的定植、繁殖以及毒素的体内产生。最初的临床发现指向格林-巴利综合征，建议对该综合征患者进行血清肉毒毒素检测以及粪便毒素和细菌检测。
