醫週譯:Botulism/肉毒桿菌中毒

Botulism (Latin, botulinus) (pronounced /ˈbɒtʃʉlɪzəm/) is a rare and potentially fatal paralytic illness caused by a toxin produced by the bacteria Clostridium botulinum. The disease begins with weakness, trouble seeing, feeling tired, and trouble speaking.This may than be followed by weakness of the arms, chest muscles and legs. The disease does not usually affect consciousness or cause a fever.[1]

’’’肉毒桿菌中毒’’’({{lang-la|botulinus}})是一種罕見但致命的[[癱瘓]]性疾病,由[[肉毒桿菌]]製造的毒素引起。患者最開始會感到無力、看不清楚、疲倦、以及說話困難,接下來則可能會出現手臂、腿、以及胸廓肌肉無力的症狀。在大多數的患者身上,通常不會[[意識]]不清或[[發熱|發燒]][1]。

<!-- Cause and Diagnosis -->

Botulism can occur in a few different ways. The bacterial spores that cause it are common in both soil and water. They produce botulinum toxin when exposed to low oxygen levels and certain temperatures. Foodborne botulism happens when food containing the toxin are eaten. Infant botulism happens when the bacteria develops in the intestines and releases toxin. Typically this only happens in children less than six months of age as after that protective mechanism develop. Wound botulism is found most often among those who inject street drugs. In this situation spores enter a wound and, in the absence of oxygen, release toxin. It is not passed directly between people. The diagnosis is confirmed by finding the toxin or bacteria in the person in question.[1]

<!-- 成因與診斷 -->

肉毒桿菌中毒通常有幾種情形:肉毒桿菌[[芽孢]]在土壤與水中都很常見,當它們暴露於缺氧且符合特定溫度的環境下時,它們就會開始製造[[肉毒桿菌素|肉毒桿菌毒素]]。食物性肉毒桿菌中毒指的是患者吃了被肉毒桿菌素汙染的食物;嬰兒肉毒桿菌中毒則是因為肉毒桿菌在嬰兒的腸道中繁殖,並釋放肉毒桿菌素,通常這種情形只發生在免疫機轉尚不完全的嬰兒(六個月大以前)如蜂蜜可能被肉毒桿菌芽孢所汙染,受汙染的蜂蜜對成年人無害,但肉毒桿菌芽孢卻可能在免疫系統不成熟的嬰兒身上生長並釋放肉毒桿菌素而致病;創傷肉毒桿菌症則在街頭濫用藥物注射毒品的人身上較為常見,但一般而言,只要肉毒桿菌進入缺氧的傷口中,它就會開始釋放毒素。肉毒桿菌並沒有人傳人的能力,診斷肉毒桿菌中毒的條件是在患者身上找到肉毒桿菌素或肉毒桿菌[1]。

<!-- Prevention and Treatment -->

Prevention is primarily by proper food preparation. The toxin is destroyed by heating to more than 85 Celsius for greater than 5 minutes. Avoiding giving children less than one year of age honey is also recommended. Treatment is with an antitoxin. In those who lose their ability to breath on their own, mechanical ventilation potentially for months may be required. Antibiotics may be used for wound botulism. Death occurs in 5 to 10% of people. Botulism can affect a number of other animals.[1]

<!-- 預防與治療 -->

預防肉毒桿菌中毒首重食物保存。毒素在大於攝氏85度的狀況下加熱超過五分鐘就會被破壞[1],或者將pH值控制在4.5以下[2]。一歲以下孩童應該儘量避免食用蜂蜜,因為蜂蜜可能被肉毒桿菌芽孢所汙染,對成年人無害,但卻可能在免疫系統不成熟的嬰兒身上生長,並釋放肉毒桿菌素而致病。治療方法是給予{{link-en|抗毒素|Antitoxin|抗細菌藥}};[[抗生素]]則可以用在創傷肉毒桿菌症;而針對那些無法自主呼吸的個案,則可能需要為期數月的{{link-en|呼吸器|Mechanical ventilation}}支持。有5-10%的個案可能死亡。肉毒桿菌中毒可能發生在其他動物上[1]。

2014-12-29 已與中文維基百科「肉毒桿菌中毒」的引言頁面整合

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