暴发性食物中毒致多器官功能衰竭致死。
Fulminant food poisoning with fatal multi-organ failure.
机构信息
Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, Sydney, Australia
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
出版信息
BMJ Case Rep. 2021 Jan 18;14(1):e238716. doi: 10.1136/bcr-2020-238716.
This case represents a rare fulminant course of fried-rice associated food poisoning in an immunocompetent person due to pre-formed exotoxin produced by , with severe manifestations of sepsis, including multi-organ (hepatic, renal, cardiac, respiratory and neurological) failure, shock, metabolic acidosis, rhabdomyolysis and coagulopathy. Despite maximal supportive measures (continuous renal replacement therapy, plasmapheresis, N-acetylcysteine infusion and blood products, and broad-spectrum antimicrobials) and input from a multidisciplinary team (consisting of infectious diseases, intensive care, gastroenterology, surgery, toxicology, immunology and haematology), mortality resulted. This case is the first to use whole genome sequencing techniques to confirm the toxigenic potential of It has important implications for food preparation and storage, particularly given its occurrence in home isolation during the COVID-19 pandemic.
本病例代表了一例罕见的免疫功能正常者因摄入预先形成的外毒素而导致炒饭相关食物中毒的暴发性病程，严重表现为脓毒症，包括多器官（肝、肾、心、呼吸和神经）衰竭、休克、代谢性酸中毒、横纹肌溶解和凝血功能障碍。尽管采取了最大的支持措施（连续肾脏替代治疗、血浆置换、N-乙酰半胱氨酸输注和血制品，以及广谱抗生素），并得到了多学科团队（包括传染病、重症监护、胃肠病学、外科、毒理学、免疫学和血液学）的支持，但仍导致了患者死亡。本病例是首例使用全基因组测序技术证实 产生毒素的潜力的病例。这对于食品制备和储存具有重要意义，特别是考虑到在 COVID-19 大流行期间在家中隔离时发生了这种情况。
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