El Ameri A, Achenani M, Hmamouche K, Ghazouani M, Benaouda A, El Ouennass M
Service de bactériologie, hôpital militaire d'instruction Mohammed V, BP 2733, Rabat, Maroc.
J Gynecol Obstet Biol Reprod (Paris). 2011 Oct;40(6):577-9. doi: 10.1016/j.jgyn.2011.02.001. Epub 2011 Mar 10.
Listeriosis in pregnancy is usually benign; however the foetal consequences are serious. We report a case of atypical listeriosis simulating pyelonephritis, in a pregnant woman who presented at 25 weeks gestation a left renal colic, operating in a febrile context; it was treated as urinary tract infection with gentamicin and ceftriaxon. The evolution was marked by the exacerbation of symptoms followed by in utero foetal death. Blood culture was performed in post abortion; the diagnosis was retained after bacteriological examination of the placenta. This observation suggested evoking listeriosis in any case of unexplained fever during pregnancy, even with clinical signs suggestive of pyelonephritis, and not delay making blood cultures and prescribing antibiotics in general an amoxicillin.
妊娠期李斯特菌病通常是良性的；然而，对胎儿的影响却很严重。我们报告一例非典型李斯特菌病，该病例表现为肾盂肾炎，一名妊娠25周的孕妇出现左肾绞痛，在发热情况下进行手术；最初被当作尿路感染用庆大霉素和头孢曲松治疗。病情发展表现为症状加重，随后胎儿宫内死亡。流产后进行了血培养；对胎盘进行细菌学检查后确诊。该病例提示，在孕期任何不明原因发热的情况下，即使有提示肾盂肾炎的临床体征，都应考虑李斯特菌病，不要延迟进行血培养及使用抗生素，一般应使用阿莫西林。
