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巴西亚马逊地区的肉毒中毒:被忽视人群中的一种危及生命的疾病。

Botulism in the Brazilian Amazon: a life-threatening disease in a neglected population.

机构信息

Universidade Federal do Amazonas, Faculdade de Medicina, Manaus AM, Brazil.

Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus AM, Brazil.

出版信息

Arq Neuropsiquiatr. 2022 Dec;80(12):1227-1232. doi: 10.1055/s-0042-1758651. Epub 2022 Dec 29.

Abstract

BACKGROUND

Botulism is a rare and potentially fatal neuroparalytic syndrome caused by the gram-positive anaerobe spore-forming bacterium . The microorganism produces a neurotoxin that inhibits the presynaptic release of acetylcholine at the neuromuscular junction, clinically leading to a myasthenic syndrome.

OBJECTIVE

To describe the recent outbreak of botulism cases and its demographic, clinical, and laboratory characteristics.

METHODS

We report 4 patients with botulism in the recent outbreak occurred between 2017 and 2019 in the state of Amazon.

RESULTS

Out of four patients with botulism, three contracted it from eating contaminated food and one had wound botulism. We emphasize the excellent clinical outcome of the different disease presentations in our case series.

CONCLUSION

The temporal proximity of these reports may suggest a new rise in the number of cases in the upcoming years. A possible hypothesis is that the rarity of the disease decreased the awareness regarding the primary prevention or even a diagnosis by an untrained physician.

摘要

背景

肉毒中毒是一种罕见且潜在致命的神经麻痹综合征,由革兰阳性厌氧产孢子细菌引起。该微生物产生一种神经毒素,抑制运动终板处乙酰胆碱的前突触释放,临床上导致肌无力综合征。

目的

描述最近发生的肉毒中毒病例及其人口统计学、临床和实验室特征。

方法

我们报告了 2017 年至 2019 年在亚马逊州发生的最近一次肉毒中毒暴发中的 4 例患者。

结果

4 例肉毒中毒患者中,3 例因食用受污染的食物而感染,1 例为创伤性肉毒中毒。我们强调了我们病例系列中不同疾病表现的出色临床转归。

结论

这些报告的时间接近可能表明未来几年病例数量的新增加。一种可能的假设是,这种疾病的罕见性降低了对初级预防甚至未经训练的医生诊断的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/9800156/4d0bfaa04ffc/10-1055-s-0042-1758651-i210457-1.jpg

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