PDF(Pubmed)
Abstract：
BACKGROUND: Clostridium botulinum is an anaerobic, Gram-positive, rod-shaped bacterium that forms spores and the neurotoxin botulinum. It is best known for its toxin-induced flaccid paralytic disease, which is deadly without correct treatment. In this report, we show a completely different clinical course with fatal outcome.
METHODS: A 37-year-old African man born in Sierra Leone was admitted. After admission, his condition rapidly worsened due to severe septic shock and progressive multiorgan failure. No neurological signs were seen. Despite treatment with antibiotics, fluid resuscitation, and norepinephrine, the multiorgan failure deteriorated further and he died as a result. Blood and synovial fluid cultures showed Clostridium botulinum. No botulinum toxins were found.
CONCLUSIONS: This is a rare case of fatal septic shock due to Clostridium botulinum-induced septic arthritis without any sign of the classic clinical syndrome of botulism.
METHODS: A 37-year-old African man born in Sierra Leone was admitted. After admission, his condition rapidly worsened due to severe septic shock and progressive multiorgan failure. No neurological signs were seen. Despite treatment with antibiotics, fluid resuscitation, and norepinephrine, the multiorgan failure deteriorated further and he died as a result. Blood and synovial fluid cultures showed Clostridium botulinum. No botulinum toxins were found.
CONCLUSIONS: This is a rare case of fatal septic shock due to Clostridium botulinum-induced septic arthritis without any sign of the classic clinical syndrome of botulism.
摘要：
背景：肉毒梭菌是一种厌氧菌，革兰氏阳性,形成孢子的杆状细菌和肉毒杆菌神经毒素。它以毒素诱发的弛缓性麻痹病而闻名，如果没有正确的治疗是致命的。在这份报告中,我们显示了一个完全不同的临床过程与致命的结果。
方法：一名出生在塞拉利昂的37岁非洲男子入院。入院后,由于严重的感染性休克和进行性多器官衰竭，他的病情迅速恶化。没有看到神经系统的迹象。尽管用抗生素治疗，液体复苏,去甲肾上腺素,多器官衰竭进一步恶化，他因此死亡。血液和滑液培养显示肉毒梭菌。没有发现肉毒杆菌毒素。
结论：这是一例罕见的由肉毒梭菌诱导的脓毒性关节炎引起的致命性脓毒性休克，没有任何典型的肉毒中毒临床综合征的迹象。
方法：一名出生在塞拉利昂的37岁非洲男子入院。入院后,由于严重的感染性休克和进行性多器官衰竭，他的病情迅速恶化。没有看到神经系统的迹象。尽管用抗生素治疗，液体复苏,去甲肾上腺素,多器官衰竭进一步恶化，他因此死亡。血液和滑液培养显示肉毒梭菌。没有发现肉毒杆菌毒素。
结论：这是一例罕见的由肉毒梭菌诱导的脓毒性关节炎引起的致命性脓毒性休克，没有任何典型的肉毒中毒临床综合征的迹象。
