Swartland Hospital, Malmesbury, South Africa.
National Health Laboratory Service, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Int J Infect Dis. 2021 Feb;103:164-166. doi: 10.1016/j.ijid.2020.11.131. Epub 2020 Nov 17.
Botulism, a rare life-threatening toxemia, is probably underdiagnosed in all of its forms in Africa. This study reports the first laboratory-supported case of infant botulism on the African continent. A 10-week-old, previously well infant presented with progressive global weakness, feeding difficulty, and aspiration pneumonia. During a lengthy hospitalization, a rare bivalent Clostridium botulinum strain, producing subtype B3 and F8 toxins and with a new multilocus sequence type, was isolated from stool. The infant was successfully treated with a heptavalent botulinum antitoxin infusion and pyridostigmine. Despite the relative rarity of infant botulism, this case illustrates the importance of maintaining a high level of clinical suspicion when assessing hypotonic infants. The value of modern diagnostic modalities in identifying and characterizing this under-recognized condition is also demonstrated.
肉毒中毒是一种罕见的危及生命的毒血症，在非洲的所有形式中可能都被低估了。本研究报告了非洲大陆首例实验室支持的婴儿肉毒中毒病例。一名 10 周大、既往健康的婴儿出现进行性全身无力、喂养困难和吸入性肺炎。在长时间住院期间，从粪便中分离出一种罕见的二价肉毒梭状芽孢杆菌菌株，该菌株产生 B3 和 F8 型毒素，具有新的多位点序列类型。婴儿成功接受了七价肉毒杆菌抗毒素输注和吡啶斯的明治疗。尽管婴儿肉毒中毒相对罕见，但该病例说明了在评估低张力婴儿时保持高度临床怀疑的重要性。现代诊断方法在识别和描述这种认识不足的疾病方面的价值也得到了证明。
