Hospital de Mataró. Consorci Sanitari del Maresme, 08304 Mataró, España.
Rev Neurol. 2022 Aug 1;75(3):71-74. doi: 10.33588/rn.7503.2021294.
Botulism is a potentially fatal neuroparalytic syndrome caused by Clostridium botulinum neurotoxin. The 25% are food-borne botulism cases.
We describe a confirmed case of botulism attended in our hospital in September 2020, together with a second case in a patient's relative, suspected but not confirmed by laboratory tests. Clinical presentation consisted on general weakness, bilateral cranial palsy, mydriasis, and rapidly progressive tetraparesis in case 1, involving respiratory and swallowing function so she required hospitalization and support treatment. Non specific and transient symptoms occurred in case 2. SARS-CoV-2 infection was initially suspected in both cases due to pandemic situation in our country, ruled out by negative PCR. When B neurotoxin was detected in stool sample of patient 1 we confirmed the diagnosis of food-borne botulism probably linked to home-made conserved beans.
Early clinical suspicion, together with laboratory and electromyography findings, and support treatment provided at hospital were crucial for favourable outcome. Being aware of this rare syndrom might contribute to its better management.
肉毒中毒是一种由肉毒梭菌神经毒素引起的潜在致命神经瘫痪综合征。25%的病例为食源性肉毒中毒。
我们描述了 2020 年 9 月在我院收治的 1 例确诊肉毒中毒病例，以及 1 例疑似病例（患者的亲属），但实验室检测未确认。1 例患者的临床表现为全身无力、双侧颅神经瘫痪、瞳孔散大，随后迅速进展为四肢瘫痪，累及呼吸和吞咽功能，因此需要住院并接受支持治疗。2 例患者均出现非特异性和短暂性症状。由于我国正处于大流行期间，最初怀疑这两例患者均感染了 SARS-CoV-2，经聚合酶链反应（PCR）检测为阴性，排除了这一可能。当在 1 例患者的粪便样本中检测到 B 型神经毒素时，我们确诊为食源性肉毒中毒，可能与自制的腌豆有关。
早期临床怀疑、实验室和肌电图检查结果以及在医院提供的支持治疗对良好的预后至关重要。了解这种罕见的综合征可能有助于更好地管理。
