Hughes J M, Blumenthal J R, Merson M H, Lombard G L, Dowell V R, Gangarosa E J
Ann Intern Med. 1981 Oct;95(4):442-5. doi: 10.7326/0003-4819-95-4-442.
Medical records of 55 patients with type A and type B food-borne botulism reported to the Centers for Disease Control during 2 years were reviewed to assess the clinical features and severity of illness, diagnostic test results, nature of complications, amd causes of death. Some patients had features not usually associated with botulism including paresthesia (14%), asymmetric extremely weakness (17%), asymmetric ptosis (8%), slightly elevated cerebrospinal fluid protein values (14%), and positive responses to edrophonium chloride(26%). Several observation suggest that type A was more severe than type B disease. Although the case-fatality ratio was not significantly greater, patients with type A disease saw a physician earlier in the course of illness, were more likely to need ventilatory support, and were hospitalized longer. Patients who died were older than those who survived. Deaths within the first 2 weeks resulted from failure to recognized the severity of the disease or from pulmonary or systemic infection whereas the three late deaths were related to respirator malfunction.
对两年内向疾病控制中心报告的55例甲型和乙型食源性肉毒中毒患者的病历进行了回顾，以评估疾病的临床特征和严重程度、诊断测试结果、并发症的性质以及死亡原因。一些患者具有通常与肉毒中毒无关的特征，包括感觉异常（14%）、不对称性极度虚弱（17%）、不对称性上睑下垂（8%）、脑脊液蛋白值略有升高（14%）以及对氯化腾喜龙呈阳性反应（26%）。几项观察结果表明，甲型疾病比乙型疾病更严重。虽然病死率没有显著更高，但甲型疾病患者在病程中更早看医生，更有可能需要通气支持，住院时间更长。死亡患者比存活患者年龄更大。前两周内的死亡是由于未认识到疾病的严重性或肺部或全身感染，而三例晚期死亡与呼吸机故障有关。
