Nursing experience of a case of infant botulinum toxin poisoning
一例婴儿肉毒杆菌中毒的护理体会

摘要

肉毒杆菌并不能直接引起中毒，通常会在适宜环境条件中让其孢子发芽，而孢子发芽的情况极为罕见，需同时满足无氧、低酸度（pH>4.5）、低盐和低糖以及适宜的温度等多个条件才会产生外毒素——嗜神经毒素，其毒素比砒霜还大一万倍，是目前发现的毒性最强的毒物之一。总结一例婴儿肉毒杆菌中毒的护理措施。护理要点：早期识别婴儿肉毒杆菌中毒，采集标准粪便和血清筛查，尽早使用特异疗法（肉毒杆菌抗毒素），及时有效的救治对预后至关重要；同时制定个体化营养支持方案，保持肠道的通畅，肉毒抗毒素过敏发生率极高，严密观察治疗的不良反应，呼吸机支持治疗、皮肤的护理及粪菌移植护理等制定随访计划，做好延续性护理。经过积极治疗和精心护理，患儿病情好转，顺利转入普通病房。

Abstract

Clostridium botulinum cannot directly cause poisoning. Its spores usually germinate under suitable environmental conditions, and spore germination is extremely rare. It requires multiple conditions such as anaerobic, low acidity (pH>4.5), low salt and low sugar, and suitable temperature to produce exotoxins - neurotoxins. Its toxin is 10000 times larger than arsenic and is currently one of the most toxic toxins discovered. Summarize the nursing measures for a case of infant botulinum toxin poisoning. Nursing points: Early identification of infant botulinum toxin, collection of standard feces and serum screening, early use of specific therapy (botulinum toxin antitoxin), and timely and effective treatment are crucial for prognosis; At the same time, an individualized nutritional support plan should be developed to maintain intestinal patency. The incidence of botulinum toxin allergy is extremely high, and adverse reactions to treatment should be closely observed. Follow up plans should be developed for respiratory support therapy, skin care, and fecal microbiota transplantation care to ensure continuity of care. After active treatment and careful care, the child's condition improved and they were successfully transferred to a regular ward.