Abdallah Mohamed A, Rank Kevin M, Keeley Scott, Anderson Daniel J, Vaughn Byron P
Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, University of Minnesota, Minneapolis, MN.
Minnesota Gastroenterology P.A., Coon Rapids, MN.
ACG Case Rep J. 2021 Dec 28;9(1):e00718. doi: 10.14309/crj.0000000000000718. eCollection 2022 Jan.
Adult intestinal toxemia botulism (ITB) is a rare illness that can be fatal if not recognized. ITB can occur when botulinum neurotoxin-producing clostridia colonize the intestine. Underlying intestinal abnormalities associated with dysbiosis are likely a prerequisite for colonization. Dysbiosis seems necessary for spore germination and neurotoxin production. Botulism neurotoxins are the most lethal poisons known and are classified into 7 serotypes: A through G. The clinical presentation consists of cranial nerve abnormalities and descending flaccid paralysis. Prompt recognition and treatment with botulism antitoxin and supportive measures is often successful, but delayed recognition can be fatal. In this study, we present a case of a 40-year-old woman with Crohn's disease who developed ITB. This is the first case in literature to report adult intestinal botulism from producing toxin B and F in the same patient.
成人肠道型肉毒中毒（ITB）是一种罕见疾病，若未被识别可能会致命。当产生肉毒杆菌神经毒素的梭状芽孢杆菌在肠道定植时，就可能发生ITB。与肠道菌群失调相关的潜在肠道异常可能是定植的先决条件。肠道菌群失调似乎是孢子萌发和神经毒素产生所必需的。肉毒杆菌神经毒素是已知最致命的毒素，分为7种血清型：A至G。临床表现包括颅神经异常和下行性弛缓性麻痹。及时识别并用肉毒中毒抗毒素及支持措施进行治疗通常会成功，但识别延迟可能会致命。在本研究中，我们报告了一例40岁克罗恩病女性发生ITB的病例。这是文献中首例报告同一患者产生毒素B和F的成人肠道型肉毒中毒病例。
