食物肉毒杆菌中毒F

Irina V. Nikolaeva, F. S. Gilmullina, Aleksander Yu. Kazancev, B. S. Fatkullin
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摘要

本病例描述了一名罕见的食物肉毒杆菌F病例,该病例发生在一名42岁的男子食用干鱼后。病情进展严重,发展为眼麻痹、四肢麻痹和呼吸衰竭。给予患者抗肉毒杆菌毒素A、B和E的单价抗毒血清。然而,在疾病的第三天,他发生了暴发性中毒性心肌炎,并停止跳动。尽管成功复苏,患者出现复苏后疾病和缺氧性脑病。患者合并肺炎克雷伯菌(ESBL+)引起的严重吸入性肺炎。机械通气时间12 d。发病第8天血流动力学稳定,发病第19天出现身体活动和最低意识状态。患者于发病第22天转至康复科。应告知医生由f型肉毒杆菌毒素引起的肉毒中毒的发展可能性和严重程度。有必要在临床实践中引入多价抗肉毒杆菌血清,包括针对罕见类型肉毒杆菌毒素的抗毒素。
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The case of food botulism F
This case describes a rare case of food botulism F in a 42-year-old man, which developed after he ate dried fish. The disease proceeded in a severe form with the development of ophthalmoplegia, tetraparesis, and respiratory failure. Monovalent antitoxic serums against botulinum toxins A, B, and E were administered to the patient. However, on the third day of the disease, he developed fulminant toxic myocarditis with asystole. Despite successful resuscitation, the patient developed a post-resuscitation disease and anoxic encephalopathy. The disease was complicated by severe aspiration pneumonia caused by Klebsiella pneumoniae (ESBL+). The duration of mechanical ventilation was 12 days. His hemodynamics stabilized on the eighth day of illness, and on the 19th day of illness, physical activity and a state of minimal consciousness appeared. The patient was transferred to the rehabilitation department on the 22nd day of the illness. Doctors should be informed about the possibility of the development and severity of botulism caused by botulinum toxin type F. It is necessary to introduce polyvalent antibotulinic serum into clinical practice, including antitoxins against rare types of botulinum toxin.
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