158.4 📌 章末速蚘

  • C. botulinum — anaerobe, spore; toxin 最毒
  • 7 types (A, B, E human main); cleaves SNAREs
  • Flaccid + descending + CN first + 4 D’s
  • Sensorium clear, no fever, no sensory
  • 4 forms: foodborne, infant, wound, iatrogenic
  • Tx: BAT (equine) ASAP + supportive vent + (BabyBIG for infants)
  • Wound: + debridement + metronidazole/PCN
  • 侍甹 antibiotic for foodborne / infant
  • Honey < 1 yr NO
  • EMG: incremental at high-freq (pre-synaptic, like LEMS)
  • Botulism flaccid vs Tetanus spastic — 對照孞