Shahban Shafiq Arif, Manjula Natarajan, Siddiqui Shabih
Academic FY2, Leicester Royal Infirmary, Leicester, LE1 5WW, UK.
Int J Surg Case Rep. 2012;3(9):448-50. doi: 10.1016/j.ijscr.2012.05.012. Epub 2012 Jun 1.
Listeria monocytogenes is a food borne bacterial pathogen which is rarely encountered in the United Kingdom. This rare and potentially life threatening infection has a high mortality rate and therefore requires early antimicrobial intervention.
A case report of a patient who developed Listeria septicaemia following insertion of a dynamic hip screw is described. This 84 year old immunocompromised lady had a mechanical fall at home, from which she sustained a left neck of femur fracture. She had a background of rheumatoid arthritis, and for the last 10 years had been taking 5mg prednisolone daily. After early surgical intervention with a dynamic hip screw, she developed Listeria septicaemia, following which she was treated successfully with ampicillin and gentamicin.
Infection with unusual pathogens is not uncommon amongst immunocompromised patients. Regardless of the cause, this cohort of patients' requires increased post operative surveillance to ensure that such a complication does not go unnoticed.
This case report demonstrates the importance of having a low threshold for investigation in immunocompromised patients whilst also stressing the significance of early diagnosis and intervention.
单核细胞增生李斯特菌是一种食源性细菌病原体，在英国很少见。这种罕见且可能危及生命的感染死亡率很高，因此需要早期抗菌干预。
描述了一例患者在植入动力髋螺钉后发生李斯特菌败血症的病例报告。这位84岁的免疫功能低下女性在家中不慎摔倒，导致左股骨颈骨折。她有类风湿关节炎病史，过去10年每天服用5毫克泼尼松龙。在早期通过动力髋螺钉进行手术干预后，她发生了李斯特菌败血症，随后用氨苄西林和庆大霉素成功治疗。
在免疫功能低下的患者中，感染不常见病原体并不罕见。无论病因如何，这类患者术后都需要加强监测，以确保不会忽视此类并发症。
本病例报告表明，对免疫功能低下的患者进行检查的阈值要低，同时强调早期诊断和干预的重要性。
