[肉毒中毒：一例病例报告及文献综述]
[Botulism: A case report and literature review].
作者信息
Gendrot M, Passeron A, Michon A, Pouchot J
机构信息
Service de médecine interne, université Paris Descartes, AP-HP Centre-université de Paris, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris.
Service de médecine interne, université Paris Descartes, AP-HP Centre-université de Paris, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris.
出版信息
Rev Med Interne. 2020 Jul;41(7):485-488. doi: 10.1016/j.revmed.2020.01.006. Epub 2020 Feb 12.
INTRODUCTION
Botulism is a rare syndrome resulting from the action of a neurotoxin produced by Clostridium botulinum, that it is potentially life threatening if diagnosis is delayed.
CASE REPORT
We report a 26-year-old woman who presented an acute onset of bilateral cranial neuropathies associated with an anticholinergic syndrome in the absence fever leading to consider and confirm the diagnosis of botulism. At the end of follow-up, 7 weeks later, the outcome was favorable with an almost complete neurologic recovery.
CONCLUSION
Although botulism is uncommon, better awareness of its manifestations and high clinical suspicion should shorten diagnostic delay that makes the use of specific antitoxin ineffective. An acute onset of a bilateral oculomotor palsy, a fixed pupillary dilation and descending weakness in the absence of fever is typical of botulism. Outcome is usually favorable with a slow but full neurological recovery.
引言
肉毒中毒是一种由肉毒杆菌产生的神经毒素作用导致的罕见综合征，如果诊断延迟，可能会危及生命。
病例报告
我们报告了一名26岁女性，她在无发热的情况下急性起病，出现双侧颅神经病变并伴有抗胆碱能综合征，从而考虑并确诊为肉毒中毒。在7周后的随访结束时，预后良好，神经功能几乎完全恢复。
结论
尽管肉毒中毒并不常见，但提高对其表现的认识并保持高度临床怀疑应能缩短诊断延迟，而诊断延迟会使使用特异性抗毒素无效。无发热情况下急性起病的双侧动眼神经麻痹、固定性瞳孔散大及下行性肌无力是肉毒中毒的典型表现。预后通常良好，神经功能虽恢复缓慢但完全。
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