Mechem C C, Walter F G
Department of Emergency Medicine, Valley Medical Center, Fresno, CA.
Vet Hum Toxicol. 1994 Jun;36(3):233-7.
All published cases of wound botulism were reviewed to describe the epidemiology, clinical manifestations, diagnosis, and treatment of this rare infection. The MEDLINE data base of English-language literature was searched from 1966 to 1992, using the keywords "wound botulism". Cases published during this period were identified, and the bibliographies of these articles were used to identify cases published before MEDLINE's search limit of 1966. Because of the limited number of published cases, all were reviewed. Data related to epidemiology, clinical manifestations, diagnosis and treatment were collected on each case. When possible, cross-references from case series or reviews were used to corroborate and supplement data for a given case. There were 40 cases identified as wound botulism. The case fatality rate was 10%. The 36 survivors had significant morbidity requiring prolonged medical care. Wound botulism is a rare life-threatening complication of trauma and i.v. drug abuse. The diagnosis should be considered in any patient with either of these risk factors who develop paresis of cranial nerves and a descending pattern of weakness. Treatment, including administration of antitoxin, should be initiated prior to definitive diagnosis by microbiologic laboratory tests.
对所有已发表的创伤性肉毒中毒病例进行了回顾，以描述这种罕见感染的流行病学、临床表现、诊断和治疗。使用关键词“创伤性肉毒中毒”对1966年至1992年的英文文献MEDLINE数据库进行了检索。确定了在此期间发表的病例，并利用这些文章的参考文献来确定在MEDLINE 1966年检索限制之前发表的病例。由于已发表病例数量有限，对所有病例都进行了回顾。收集了每个病例的流行病学、临床表现、诊断和治疗相关数据。如有可能，利用病例系列或综述中的交叉引用，来证实和补充给定病例的数据。共确定了40例创伤性肉毒中毒病例。病死率为10%。36名幸存者有严重的发病率，需要长期医疗护理。创伤性肉毒中毒是创伤和静脉药物滥用的一种罕见的危及生命的并发症。对于有上述任何一种危险因素且出现颅神经麻痹和下行性肌无力的患者，均应考虑诊断。在通过微生物实验室检查确诊之前，应开始包括给予抗毒素在内的治疗。
