Clinical features of foodborne botulism associated with one local outbreak
10.3760/cma.j.issn.1671-0282.2020.10.014
- VernacularTitle:群体性食源性肉毒杆菌中毒的临床特征
- Author:
Chen CHAI
1
;
Lei FAN
;
Lei WANG
;
Yuying WEN
;
Cao PENG
;
Xiangdong CHENG
;
Meixia LV
;
Zehai TANG
Author Information
1. 华中科技大学同济医学院附属协和医院急诊科，武汉 430022
- From:
Chinese Journal of Emergency Medicine
2020;29(10):1322-1327
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Analyze the epidemiological data and the clinical data of local foodborne botulism, summarize the influencing factors and clinical characteristics of the foodborne botulism, mitigate future misdiagnosis.Methods:An epidemiological investigation was conducted to a local outbreak with botulism, which involved 24 individuals consuming homemade bean curd and 14 cases with foodborne botulism through analyzing the influencing factors of the poisoning. For 14 patients with botulism, their clinical manifestations, first laboratory test and imaging data, treatment and prognosis, were documented and explored.Results:All 14 cases were diagnosed as type A foodborne botulism, of which 2 were misdiagnosed. The incidence of the foodborne botulism was reduced by 81.7% in alcoholic drinkers ( P=0.009). The median incubation period of the 14 patients with botulism was 2.0 (1.0~3.0) days. The initial clinical symptom of 10 patients was diplopia, while that of the other 4 patients was blurred vision. Nine patients subsequently suffered from paralysis of oropharyngeal muscles, leading to dysphagia, speech impairment, etc. Four patients progressed to dyspnea and chest tightness due to respiratory muscle involvement. All of the patients had clear consciousness without sensory abnormalities, no fever and abdominal symptoms such as diarrhea and abdominal pain. There were no obvious abnormal findings in 14 patients with laboratory tests and cranial CT/MRI assessment. 14 patients with the poisoning were relieved after injection of botulinum antitoxin for 8.0 (7.0~8.5) days. Follow-up of all the patients 6 months later found that 9 patients still had slight blurred vision. Conclusions:The typical clinical manifestation of foodborne botulism was symmetric descending flaccid paralysis. Drinking liquor could reduce the incidence of foodborne botulism. Botulinum antitoxin was effective in the treatment of botulism and should be used as early as possible.
