Kim Byung Sihk, Kim Tae Yeob, Kim Ji Yeoun, Yoo Kyo Sang, Jeon Yong Chul, Han Dong Soo, Sohn Joo Hyun, Kim Jieun
Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Korean J Gastroenterol. 2013 Sep;62(3):179-81. doi: 10.4166/kjg.2013.62.3.179.
Spontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with ascites caused by advanced liver disease. While gram negative bacteria, such as Escherichia coli and Klebsiella pneumonia are the common pathogens, Listeria monocytogenes has been recognized as a very rare pathogen. Empirical treatment with third generation cephalosporins does not provide adequate antibiotics coverage against L. monocytogenes. Diagnosis is often delayed as it requires confirmation from ascitic fluid culture. Herein, we describe the first case of SBP caused by L. monocytogenes in a patient with advanced alcoholic liver cirrhosis in Korea. Clinicians should be aware of the atypical pathogens, especially in patients with inadequate response to empirical antibiotics.
自发性细菌性腹膜炎（SBP）是晚期肝病所致腹水患者的一种危及生命的并发症。虽然革兰氏阴性菌，如大肠杆菌和肺炎克雷伯菌是常见病原体，但单核细胞增生李斯特菌已被公认为一种非常罕见的病原体。使用第三代头孢菌素进行经验性治疗并不能提供足够的抗生素覆盖范围来对抗单核细胞增生李斯特菌。由于需要腹水培养来确诊，诊断往往会延迟。在此，我们描述了韩国首例由单核细胞增生李斯特菌引起的晚期酒精性肝硬化患者的SBP病例。临床医生应警惕非典型病原体，尤其是对经验性抗生素治疗反应不佳的患者。
