Aureli P, Fenicia L, Pasolini B, Gianfranceschi M, McCroskey L M, Hatheway C L
J Infect Dis. 1986 Aug;154(2):207-11. doi: 10.1093/infdis/154.2.207.
The first two confirmed cases of type E infant botulism occurred in two 16-week-old girls in Rome, Italy. The original diagnosis for the first patient was intestinal blockage due to an ileocecal invagination, which was treated surgically. Postoperatively, the patient became unresponsive and required ventilatory assistance. A diagnosis of infant botulism was then made. The second infant presented to the same hospital 7 1/2 months later with profound weakness, hypotonicity, mydriasis, and areflexia. This case was recognized as possible botulism at admission. Both cases were confirmed by detection and identification of type E botulinal toxin in stool specimens and in enrichment cultures of those specimens. The toxigenic organisms isolated were quite different from Clostridium botulinum type E. The apparent causative organism in each case resembles Clostridium butyricum but produces a neurotoxin that is indistinguishable from type E botulinal toxin by its effects on mice and by its neutralization with type E botulinal antitoxin.
首例两例确诊的E型婴儿肉毒中毒病例发生在意大利罗马的两名16周大的女童身上。首例患者最初被诊断为因回盲部肠套叠导致的肠梗阻，并接受了手术治疗。术后，患者失去反应，需要通气辅助。随后确诊为婴儿肉毒中毒。7个半月后，第二名婴儿因严重虚弱、肌张力减退、瞳孔散大及反射消失被送至同一家医院。该病例在入院时被认定可能为肉毒中毒。两例均通过在粪便标本及这些标本的增菌培养物中检测和鉴定E型肉毒毒素得到确诊。分离出的产毒生物与E型肉毒梭菌有很大不同。每例中明显的致病生物类似丁酸梭菌，但产生的神经毒素在对小鼠的作用及用E型肉毒抗毒素中和方面与E型肉毒毒素无法区分。
