Valencia Ortega M E, Enríquez Crego A, Laguna Cuesta F, Ortega Millán G, González Lahoz J M
Servicio de Enfermedades Infecciosas, Hospital Carlos III, Madrid.
An Med Interna. 2000 Dec;17(12):649-51.
Although resistance to Listeria monocytogenes infection requires intact T-cell mediated immunity, listeriosis is an infrequent problem in patients with HIV infection and only about 50 patients have been reported to date. Only two patients with HIV and L. monocytogenes have been attended in our hospital since the beginning of aids epidemic in 1981. Case 1: a man with HIV and 364 CD4+ cells/mm3 presented fever and occipital headache. The cerebral scan was normal and L. monocytogenes grew in licuor culture. He was outcome after treatment with ampicillin and tobramycin. Case 2: a 47 years old man with HIV, 44 CD4+ cells/mm3 and hepatic virus C cirrhosis was admitted to the hospital because fever and abdominal distension. He was on menstrual pentamidine prophylaxis for Pneumocystis carinii pneumonia (PCP). Bacterial peritonitis was diagnosed and the patient begun treatment with ceftriaxone. The patient dead 72 hours later with hepatic encepholopathy. Postmortem L. monocytogenes grew. Listeriosis is an infrequent disease in patients with HIV that causes difficult diagnostic problems, principally in patients without prophylaxis with cotrimoxazole for PCP.
虽然对单核细胞增生李斯特菌感染的抵抗力需要完整的T细胞介导的免疫，但李斯特菌病在HIV感染患者中是一个罕见问题，迄今为止仅报告了约50例患者。自1981年艾滋病流行开始以来，我院仅诊治过2例HIV合并单核细胞增生李斯特菌感染的患者。病例1：一名HIV患者，CD4+细胞计数为364个/mm³，出现发热和枕部头痛。脑部扫描正常，脑脊液培养中培养出单核细胞增生李斯特菌。经氨苄西林和妥布霉素治疗后好转。病例2：一名47岁的HIV患者，CD4+细胞计数为44个/mm³，患有丙型肝炎肝硬化，因发热和腹胀入院。他正在接受喷他脒预防卡氏肺孢子虫肺炎（PCP）。诊断为细菌性腹膜炎，患者开始用头孢曲松治疗。患者在72小时后死于肝性脑病。尸检培养出单核细胞增生李斯特菌。李斯特菌病在HIV患者中是一种罕见疾病，会导致诊断难题，主要发生在未接受复方新诺明预防PCP的患者中。
