Hristea I, Bunnapradist S, Peng A, Puliyanda D, Vo A, Jordan S C
Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Transpl Infect Dis. 2007 Jun;9(2):142-7. doi: 10.1111/j.1399-3062.2007.00211.x.
Renal transplant recipients are at increased risk for life-threatening complications, most commonly infections. Because of their impaired cell-mediated immunity, these patients are particularly susceptible to organisms that rely on intracellular survival and spread, such as Listeria monocytogenes. Despite being a food-borne pathogen, L. monocytogenes is associated with significant morbidity and mortality. Here we report the case of a renal transplant recipient who developed rapidly progressive neurological symptoms after a brief gastrointestinal illness. Magnetic resonance imaging scan of the brain showed a large mass that was identified as an abscess due to L. monocytogenes. Timely aspiration and antibiotic treatment resulted in complete recovery, as opposed to worse outcomes in the available case reports. We further review the epidemiology, microbiology, clinical presentation, and therapeutic options for listerial brain abscess.
肾移植受者出现危及生命并发症的风险增加，最常见的是感染。由于其细胞介导的免疫功能受损，这些患者特别容易感染那些依赖细胞内存活和传播的病原体，如单核细胞增生李斯特菌。尽管单核细胞增生李斯特菌是一种食源性病原体，但它与显著的发病率和死亡率相关。在此，我们报告一例肾移植受者在短暂的胃肠道疾病后迅速出现进行性神经症状的病例。脑部磁共振成像扫描显示有一个大肿块，经鉴定为由单核细胞增生李斯特菌引起的脓肿。及时的穿刺抽吸和抗生素治疗使患者完全康复，这与现有病例报告中的较差结果形成对比。我们进一步回顾了李斯特菌性脑脓肿的流行病学、微生物学、临床表现和治疗选择。
