Yildiz Orhan, Aygen Bilgehan, Esel Duygu, Kayabas Uner, Alp Emine, Sumerkan Bulent, Doganay Mehmet
Department of Infectious Diseases, Faculty of Medicine, Erciyes University, 38039 Kayseri, Turkey.
Yonsei Med J. 2007 Jun 30;48(3):433-9. doi: 10.3349/ymj.2007.48.3.433.
This study focused on the effect of immuno-compromising conditions on the clinical presentation of severe listerial infection.
Nine human listeriosis cases seen from 1991-2002 were reviewed. All adult patients, from whose blood, peritoneal fluid or cerebrospinal fluid (CSF) the L. monocytogenes was isolated, were included in this retrospective study.
Listeriosis presented as primary sepsis with positive blood cultures in 5 cases and meningitis with positive CSF cultures in 4 cases. All of these patients had at least one underlying disease, most commonly, hematologic malignancy, diabetes mellitus, amyloidosis and hepatic cirrhosis; 55.6% had received immunosuppressive or corticosteroid therapy within a week before the onset of listeriosis. The patients were adults with a mean age of 60 years. Fever, night sweats, chills and lethargy were the most common symptoms; high temperature (> 38 degrees C), tachycardia, meningeal signs and poor conditions in general were the most common findings on admission. The mortality rate was 33.3% and was strictly associated with the severity of the underlying disease. Mortality differences were significant between sepsis (20%) and meningitis (50%) patients.
Listeriosis as an uncommon infection in our region and that immuno- suppressive therapy is an important pre-disposing factor of listeriosis. Sepsis and meningitis were more common in this group of patients and had the highest case-fatality rate for food-borne illnesses.
本研究聚焦于免疫功能低下状况对严重李斯特菌感染临床表现的影响。
回顾了1991年至2002年间所见的9例人类李斯特菌病病例。所有从血液、腹腔积液或脑脊液（CSF）中分离出单核细胞增生李斯特菌的成年患者均纳入本回顾性研究。
李斯特菌病表现为原发性败血症且血培养阳性5例，脑膜炎且脑脊液培养阳性4例。所有这些患者均至少有一种基础疾病，最常见的是血液系统恶性肿瘤、糖尿病、淀粉样变性和肝硬化；55.6%的患者在李斯特菌病发病前一周内接受过免疫抑制或糖皮质激素治疗。患者为成年人，平均年龄60岁。发热、盗汗、寒战和嗜睡是最常见的症状；入院时最常见的体征是体温升高（>38摄氏度）、心动过速、脑膜刺激征和一般状况较差。死亡率为33.3%，且与基础疾病的严重程度密切相关。败血症患者（20%）和脑膜炎患者（50%）的死亡率差异显著。
李斯特菌病在我们地区是一种罕见感染，免疫抑制治疗是李斯特菌病的一个重要易感因素。败血症和脑膜炎在这组患者中更为常见，且在食源性疾病中病死率最高。
