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[围产期李斯特菌病——病例报告]

[Perinatal listeriosis--a case report].

作者信息

Cheng B R, Kuo D M, Hsieh T T

机构信息

Department of Obstetries and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.

出版信息

Changgeng Yi Xue Za Zhi. 1990 Jun 20;13(2):152-6.

PMID:2224608
Abstract

Listeria monocytogenes, an uncommon perinatal infection in human, has been reported to be correlated with abortion, premature labor, intrauterine fetal sepsis, intrauterine fetal death and neonatal infections. Reported here was the first case of perinatal listeriosis complicated with Listeria monocytogenes chorioamnionitis at 33 weeks' gestation in Taiwan. The transabdominal amniocentesis in this particular case confirmed the diagnosis. An live premature male fetus was delivered by emergency cesarean section on the next day of hospitalization due to acute fetal distress. The acute ill baby developed signs of meningitis on the following day. Blood culture of Listeriosis monocytogenes indicated early onset neonatal listeriosis. Brain sonography showed hydrocephalus after a one-month period antibiotic treatment, he was lost to follow-up one month later. A review of the literature is presented to describe the clinical, epidemiological and pathological findings and to highlight their variable presentations and procedures for management. Thus it is of great importance for obstetricians to include listeriosis as a differential diagnosis in cases of fever of unknown origin during pregnancy. Promptly obtaining proper cultures and instituting appropriate antibiotics therapy is emphasized.

摘要

单核细胞增生李斯特菌是一种在人类中不常见的围产期感染病原体,据报道与流产、早产、宫内胎儿败血症、宫内胎儿死亡及新生儿感染有关。本文报告了台湾首例妊娠33周时发生的围产期李斯特菌病合并单核细胞增生李斯特菌绒毛膜羊膜炎病例。该病例经腹羊膜腔穿刺术确诊。因急性胎儿窘迫,住院次日行急诊剖宫产娩出一名存活的早产男婴。该患病新生儿次日出现脑膜炎体征。单核细胞增生李斯特菌血培养显示为早发型新生儿李斯特菌病。抗生素治疗1个月后脑部超声检查显示脑积水,1个月后失访。本文回顾相关文献以描述其临床、流行病学及病理表现,并强调其多样的临床表现及处理方法。因此,产科医生将李斯特菌病作为孕期不明原因发热病例的鉴别诊断极为重要。强调应及时进行适当培养并给予恰当的抗生素治疗。

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