Ahmad Mufazzal, Krishnan Abirami, Kelman Elizabeth, Allen Vanessa, Bargman Joanne M
Department of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada.
Int Urol Nephrol. 2008;40(3):815-9. doi: 10.1007/s11255-008-9411-2. Epub 2008 Jun 19.
Listeria monocytogenes (LM) is one of the rare microorganisms causing peritonitis in peritoneal dialysis (PD) patients. We report a sporadic case of peritonitis caused by LM in a young female PD patient with lupus receiving corticosteroid therapy, who presented with abdominal pain, cloudy PD effluent, nausea, and conjunctivitis. The effluent showed a high PD effluent white cell count and monocytosis, and gram staining showed gram-positive bacilli in single or short chains and PD effluent culture grew LM. She was treated successfully with beta lactum antibiotics. LM peritonitis should be suspected if a patient presents with gram-positive bacilli and monocytosis in dialysis effluent.
单核细胞增生李斯特菌(LM)是导致腹膜透析(PD)患者发生腹膜炎的罕见微生物之一。我们报告了一例年轻的狼疮性PD女性患者,在接受皮质类固醇治疗时发生由LM引起的散发性腹膜炎,该患者表现为腹痛、腹膜透析流出液浑浊、恶心和结膜炎。流出液显示腹膜透析流出液白细胞计数高和单核细胞增多,革兰氏染色显示革兰氏阳性杆菌呈单链或短链状,腹膜透析流出液培养出LM。她接受β-内酰胺类抗生素治疗成功。如果患者透析流出液中出现革兰氏阳性杆菌和单核细胞增多,应怀疑李斯特菌腹膜炎。