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本文报道了首例与牙齿脓肿相关的创伤型肉毒中毒。病人为5岁儿童,左下后乳臼齿疼痛,牙医检查有龋洞,给以充填处理。一个半月后又疼痛,检查龋洞有继发感染,给予扩创、暂时性充填、红霉素和先锋4号等治疗后,牙周肿胀减轻。再限1个月后,病孩因呼吸困难、发热和衰弱而住院。无吃自制罐头史,但有在花园中常将脏手放到口中的习惯。体检有眼肌麻痹、张口小、胸锁乳突肌显著衰弱等体征。肌电图显示,20Hz电流反复刺激,面部肌肉呈增强反应。入院后给机械通气、拔牙(渗出物细菌培养阳性),同时使用A、B、E三价混合肉毒抗毒素、头孢氨噻肟、洁霉素治疗。半个月后去除气管插管后,病孩发音与吞
This article reports the first case of botulism botulism associated with dental abscess. The patient was a 5-year-old child with pain in the lower left posterior teeth molars, dental check-up with cavities and filling treatment. One and a half months after the pain, check the cavities have secondary infection, giving expansion, temporary filling, erythromycin and Pioneer 4 and other treatment, periodontal swelling reduced. One month later, the patient was hospitalized for breathing difficulties, fever and weakness. No history of canned homemade cans, but there is often the habit of putting dirty hands in the mouth in the garden. Physical examination with ophthalmoplegia, small mouth, sternocleidomastoid muscle significantly weak and other signs. Electromyography showed that 20Hz current repeated stimulation, facial muscles were enhanced response. After admission to mechanical ventilation, tooth extraction (exudate bacterial culture positive), while using A, B, E trivalent mixed botulinum toxin, cefotaxime, lincomycin treatment. After half a month after removal of the tracheal intubation, the sick child pronounces and swallows