Sanders A B, Seifert S, Kobernick M
J Fam Pract. 1983 May;16(5):987-8, 993-4, 999-1000.
Clostridium botulinum is ubiquitous in the environment, yet symptoms of botulism occur in humans only if toxin A, B, or E is ingested, absorbed in the intestine, and bound and eventually internalized in the neuronal receptors, producing neuromuscular blockade. Clinically, botulism is divided into four types: food borne, infantile, wound, and unclassified. Systemic neurological symptoms occur within 72 hours of gastrointestinal symptoms and can progress rapidly to respiratory paralysis. Diagnosis depends on a high index of suspicion, but cultures and special tests may be helpful. Treatment remains mostly supportive with good respiratory care emphasized. Use of botulism antitoxin and guanidine may be helpful in some cases.
肉毒梭菌在环境中普遍存在，但只有当毒素A、B或E被摄入、在肠道吸收、与神经元受体结合并最终内化，从而产生神经肌肉阻滞时，人类才会出现肉毒中毒症状。临床上，肉毒中毒分为四种类型：食源性、婴儿型、伤口型和未分类型。全身神经症状在胃肠道症状出现后72小时内出现，并可迅速发展为呼吸麻痹。诊断依赖于高度的怀疑指数，但培养和特殊检查可能会有帮助。治疗主要是支持性的，强调良好的呼吸护理。在某些情况下，使用肉毒中毒抗毒素和胍可能会有帮助。
