Holmaas G, Gilhus N E, Gjerde I O, Lund-Tønnessen S, Langørgen J
Anestesi/intensivavdelingen, Haukeland Sykehus, Bergen.
Tidsskr Nor Laegeforen. 1998 Nov 20;118(28):4357-9.
Botulism is a rare disease which usually is caused by preformed botulinum toxin in food. However, this article describes a case of wound botulism in a 29-year-old male heroin addict who developed progressive diplopia, dysphagia and proximal weakness of skeletal limb muscles. He needed mechanical ventilation for two weeks. The clinical diagnosis of botulism was supported by neurophysiological tests. Assays for detection of botulinum toxin and Clostridium botulinum were negative. The patient had not eaten any contaminated food the last two weeks before symptoms appeared, but he had multiple contaminated skin wounds. After treatment with botulinum antitoxins and antibiotics he gradually recovered, and six weeks later he was discharged from hospital in good condition. To the best of our knowledge this is the first case of wound botulism reported in Norway.
肉毒中毒是一种罕见疾病，通常由食物中预先形成的肉毒杆菌毒素引起。然而，本文描述了一例29岁男性海洛因成瘾者发生创伤性肉毒中毒的病例，该患者出现进行性复视、吞咽困难和肢体近端骨骼肌无力。他需要机械通气两周。神经生理学检查支持肉毒中毒的临床诊断。检测肉毒杆菌毒素和肉毒杆菌的试验均为阴性。患者在出现症状前的最后两周内未食用任何受污染食物，但他有多处受污染的皮肤伤口。经肉毒抗毒素和抗生素治疗后，他逐渐康复，六周后康复出院。据我们所知，这是挪威报告的首例创伤性肉毒中毒病例。
