Sivalingam J J, Martin P, Fraimow H S, Yarze J C, Friedman L S
Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.
Am J Gastroenterol. 1992 Dec;87(12):1839-45.
Listeria monocytogenes is a Gram-positive bacillus that is pathogenic in both the normal and compromised host. We describe Listeria peritonitis and cerebritis in a patient with cirrhosis due to non-A, non-B hepatitis, and review the 11 other cases of Listeria peritonitis reported in the English-language literature. Listeria is a rare cause of peritonitis in debilitated, older patients, with two-thirds of the cases occurring in patients with chronic liver disease. Listeria peritonitis may also occur in patients undergoing peritoneal dialysis, or in those with malignancy. Peritonitis due to Listeria is clinically similar to spontaneous bacterial peritonitis, and is associated with fever, variable abdominal pain, and neutrocytic ascites; bacteremia commonly accompanies Listeria peritonitis. This syndrome can be successfully treated with antimicrobial drugs, although the third-generation cephalosporins commonly used in the therapy of spontaneous bacterial peritonitis are not recommended. Ampicillin may be the drug of choice, with combination therapy with an aminoglycoside reserved for cases that do not respond to ampicillin alone.
单核细胞增生李斯特菌是一种革兰氏阳性杆菌，在正常宿主和免疫功能受损宿主中均具有致病性。我们描述了一例因非甲非乙型肝炎导致肝硬化的患者发生的李斯特菌性腹膜炎和脑炎，并回顾了英文文献中报道的其他11例李斯特菌性腹膜炎病例。李斯特菌是体弱、老年患者腹膜炎的罕见病因，三分之二的病例发生在慢性肝病患者中。李斯特菌性腹膜炎也可能发生在接受腹膜透析的患者或患有恶性肿瘤的患者中。李斯特菌引起的腹膜炎在临床上与自发性细菌性腹膜炎相似，与发热、程度不一的腹痛和中性粒细胞性腹水有关；菌血症常伴随李斯特菌性腹膜炎。尽管不推荐使用治疗自发性细菌性腹膜炎常用的第三代头孢菌素，但该综合征可用抗菌药物成功治疗。氨苄西林可能是首选药物，对于单独使用氨苄西林无反应的病例，可联合使用氨基糖苷类药物进行治疗。
