食源性肉毒杆菌中毒爆发，具有潜在的新管理选择。
Foodborne botulism outbreak with potential new management options.
机构信息
From the Intensive Care Services (Altalag, Badawee, Hassan, Alotaibi, Ahmed, Aljuaid, Almalki, Alahmari, Alshehri); and from the Department of Infection Control (Habiballa), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
出版信息
Saudi Med J. 2024 Jun;45(6):626-632. doi: 10.15537/smj.2024.45.6.20240419.
OBJECTIVES
To shed some light on a potential therapeutic modality that may facilitate resolution of botulism symptoms, namely 3,4-diaminopyridine (3,4-DAP).
METHODS
In Riyadh, Saudi Arabia, we recently encountered a foodborne botulism outbreak that, luckily, was discovered early. In Prince Sultan Military Medical city, we admitted, during a period of approximately 3 weeks, 15 probable cases, 2 of which were excluded due to more likely alternative diagnoses. We report in this case series 13 highly suspected cases of botulism that we encountered during the outbreak.
RESULTS
A total of 12 out of 13 patients required intensive care unit (ICU) admission, one of which required intubation. Symptoms included cranial nerve palsies, gastrointestinal symptoms, limb and respiratory muscle weakness. Patients showed clinical improvement when received botulinum antitoxin and 3,4-DAP if given early in the course of the disease.
CONCLUSION
Early admisntration of 3,4-DAP may facilitate recovery and prevent disease progression. Larger prospective trials should be carried out to confirm that.
目的
探讨一种可能有助于缓解肉毒中毒症状的治疗方法，即 3,4-二氨基吡啶（3,4-DAP）。
方法
在沙特阿拉伯的利雅得，我们最近遇到了一起食源性肉毒中毒爆发事件，幸运的是，我们及早发现了该事件。在苏丹亲王军事医学城，我们在大约 3 周的时间内收治了 15 例疑似病例，其中 2 例因更可能的其他诊断而被排除。在本病例系列中，我们报告了在此次爆发中遇到的 13 例高度疑似肉毒中毒的病例。
结果
共有 13 例患者中的 12 例需要入住重症监护病房（ICU），其中 1 例需要插管。症状包括颅神经麻痹、胃肠道症状、肢体和呼吸肌无力。如果在疾病早期给予肉毒毒素中和抗体和 3,4-DAP，患者的临床症状会有所改善。
结论
早期给予 3,4-DAP 可能有助于恢复并防止疾病进展。应进行更大规模的前瞻性试验以证实这一点。
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