中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (2): 172-176.DOI: 10.19538/j.ek2026020617

• 疑难病例大查房 • 上一篇    

从“精神反应差”到肉毒中毒诊断：1 例婴儿弛缓性瘫痪的临床思辨

  

  1. 中国医学科学院  北京协和医学院  北京协和医院儿科，北京  100730
  • 出版日期:2026-02-06 发布日期:2026-03-13
  • 通讯作者: 马明圣，电子信箱：minsaint@aliyun.com
  • 基金资助:
    首都卫生发展科研专项（2020-1-4071）

From “poor mental response” to botulism diagnosis： a clinical case study of infantile flaccid paralysis

  1. Department of Pediatrics，Peking Union Medical College Hospital，Peking Union Medical College，Chinese Academy of Medical Sciences，Beijing  100730，China
  • Online:2026-02-06 Published:2026-03-13

摘要： 报道中国医学科学院北京协和医院儿科2025年2月24日收治1例以“精神反应差”起病的婴儿肉毒中毒。患儿为7月龄女婴，出现进行性对称性肌无力、上睑下垂及便秘，常规检查无特异性异常。经多学科讨论并反复核实病史，发现蜂蜜露灌肠史，粪便检测证实为 B 型肉毒中毒。及时给予抗毒素治疗后症状明显改善。该病例提示，高质量病史采集在婴儿弛缓性瘫痪诊断中具有关键价值。

关键词:

Abstract: A case of infant botulism presenting with ‘poor mental response’ was reported， who was admitted for treatment at the Department of Pediatrics，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences on February 24，2025. A 7-month-old girl presented with progressive symmetric muscle weakness，ptosis and constipation，with no abnormalities on routine examination.Repeated history taking during multidisciplinary discussion revealed exposure to a honey-containing enema.Stool testing confirmed type B Clostridium botulinum.The patient improved rapidly after antitoxin therapy.This case highlights the critical role of high-quality history taking in diagnosing flaccid paralysis in infants.

Key words: