Chen Shih-Yu, Lu Frank Leigh, Lee Ping-Ing, Lu Chun-Yi, Chen Chien-Yi, Chou Hung-Chieh, Tsao Po-Nien, Hsieh Wu-Shiun
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2007 Feb;106(2):161-4. doi: 10.1016/S0929-6646(09)60233-3.
In Western developed countries, Listeria monocytogenesis not an uncommon pathogen in neonates. However, neonatal listeriosis has rarely been reported in Taiwan. We describe two cases collected from a single medical institute between 1990 and 2005. Case 1 was a male premature baby weighing 1558 g with a gestational age of 31 weeks whose mother had fever with chills 3 days prior to delivery. Generalized maculopapular rash was found after delivery and subtle seizure developed. Both blood and cerebrospinal fluid culture collected on the 1st day yielded L. monocytogenes. In addition, he had ventriculitis complicated with hydrocephalus. Neurologic development was normal over 1 year of follow-up after ventriculoperitoneal shunt operation. Case 2 was a 28-weeks' gestation male premature baby weighing 1180 g. Endotracheal intubation and ventilator support were provided after delivery due to respiratory distress. Blood culture yielded L. monocytogenes. Cerebrospinal fluid showed pleocytosis but the culture was negative. Brain ultrasonography showed ventriculitis. Sudden deterioration with cyanosis and bradycardia developed on the 8th day and he died on the same day. Neonatal listeriosis is uncommon in Taiwan, but has significant mortality and morbidity. Early diagnosis of perinatal infection relies on high index of suspicion in perinatal health care professionals.
在西方发达国家，单核细胞增生李斯特菌是新生儿中并不罕见的病原体。然而，台湾地区鲜有新生儿李斯特菌病的报告。我们描述了1990年至2005年间从一家医疗机构收集的两例病例。病例1是一名体重1558克、胎龄31周的男性早产儿，其母亲在分娩前3天出现发热伴寒战。分娩后发现全身斑丘疹，随后出现轻微惊厥。第1天采集的血液和脑脊液培养均检出单核细胞增生李斯特菌。此外，他还患有脑室炎并伴有脑积水。在脑室腹腔分流手术后随访1年，神经发育正常。病例2是一名胎龄28周、体重1180克的男性早产儿。因呼吸窘迫，分娩后给予气管插管和呼吸机支持。血培养检出单核细胞增生李斯特菌。脑脊液显示细胞增多，但培养为阴性。脑部超声显示脑室炎。第8天突然出现青紫和心动过缓并恶化，当天死亡。新生儿李斯特菌病在台湾并不常见，但具有显著的死亡率和发病率。围产期感染的早期诊断依赖于围产期医护人员的高度怀疑指数。
