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基于自身研究的单核细胞增生李斯特菌的临床与实验室诊断

[Clinical and laboratory diagnosis of Listeria monocytogenes on the basis of own investigations].

作者信息

Gierowska-Bogusz B, Nowicka K, Drejewicz H

机构信息

Klinika Neonatologii, Instytut Matki i Dziecka w Warszawie, ul. Kasprzaka 17a, 01-211 Warszawa, Polska.

出版信息

Med Wieku Rozwoj. 2000;4(2 Suppl 3):89-96.

PMID:11328973
Abstract

The authors have described the issues surrounding Listeria monocytogenes infection with reference to cases diagnosed and managed during the 5-year period (1995-2000) in the Clinical Department of Neonatal Pathology and Intensive Care of the National Institute of Mother and Child in Warsaw. Four cases of congenital listeriosis have been diagnosed. Some mothers presented with "flu-like" symptoms. All mothers delivered prematurely (29 hbd - 32 hbd). Among the 4 infants the most common clinical features were: perinatal asphyxia, respiratory distress, pathological icterus, haematologic abnormalities. Septicemia occurred in 50% of cases; pneumonia in 100%. Three of them presented skin manifestations; one of the neonates had mucosal abnormalities of the laryngopharynx. Cerebral sonography showed intracranial hemorrhage. One of the infants died within 7 days of birth. The other two neonates developed posthemorrhagic hydrocephalus. Only one infant has normal development. Although listeriosis appears to be not a frequent cause of perinatal infection, clinicians must be aware of Listeria, particularly in gravid patients who present with fever and "flu-like" illness and go into premature labour. Initial therapy implemented in our Department, with ampicillin and aminoglycosides seem to be the most appropriate.

摘要

作者参考华沙国家母婴研究所新生儿病理与重症监护临床部在1995年至2000年这5年期间诊断和处理的病例,描述了围绕单核细胞增生李斯特菌感染的问题。已诊断出4例先天性李斯特菌病。一些母亲出现“流感样”症状。所有母亲均早产(孕29周 - 孕32周)。在这4名婴儿中,最常见的临床特征为:围产期窒息、呼吸窘迫、病理性黄疸、血液学异常。50%的病例发生败血症;100%的病例发生肺炎。其中3例出现皮肤表现;1例新生儿有咽喉部黏膜异常。脑部超声检查显示颅内出血。1名婴儿在出生后7天内死亡。另外2名新生儿发生出血后脑积水。只有1名婴儿发育正常。尽管李斯特菌病似乎并非围产期感染的常见原因,但临床医生必须警惕李斯特菌,尤其是对于出现发热和“流感样”疾病并早产的孕妇。我们科室采用氨苄西林和氨基糖苷类药物进行的初始治疗似乎最为合适。

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