Anyfantakis Dimitrios, Volakakis Nikolaos, Kosmidou Kiriaki, Polimili Georgia, Kastanakis Serafim
Primary Health Care Centre of Kissamos; First Department of Internal Medicine, Saint George General Hospital of Chania, Crete, Greece.
Infez Med. 2014 Jun;22(2):132-5.
We report an unusual case of concurrent meningitis and infectious monoarthritis due to Listeria monocytogenes in a 65-year-old woman presenting to our department with a transient gastrointestinal tract illness. During hospitalization the patient's neurological status deteriorated, presenting signs of meningeal irritation along with signs of inflammation and oedema of the right knee. Blood cultures and cultures of the cerebrospinal fluid and of the sinovial fluid aspirate showed growth of L. monocytogenes gram positive rods. The patient received a three-week course of intravenous meropenem with significant improvement. To the best of our knowledge this is the first case of concurrent listerial meningitis and arthritis in an immunocompetent patient. Despite the rarity of the disease in healthy individuals a high index of suspicion is required for unusual manifestations of listerial infections especially among high risk groups such as the elderly.
我们报告了一例不寻常的病例,一名65岁女性因单核细胞增生李斯特菌同时并发脑膜炎和感染性单关节炎,该患者因短暂的胃肠道疾病前来我院就诊。住院期间,患者的神经状态恶化,出现脑膜刺激征以及右膝炎症和水肿迹象。血培养、脑脊液培养和滑膜液抽吸物培养显示革兰氏阳性杆菌单核细胞增生李斯特菌生长。患者接受了为期三周的静脉注射美罗培南治疗,病情有显著改善。据我们所知,这是免疫功能正常患者并发李斯特菌性脑膜炎和关节炎的首例病例。尽管该疾病在健康个体中罕见,但对于李斯特菌感染的异常表现,尤其是在老年人等高风险人群中,需要高度怀疑。