一名慢性肾衰竭患者因4b型单核细胞增生李斯特菌引发的迅速致命的败血症。
A rapidly fatal sepsis caused by listeria monocytogenes type-4b in a patient with chronic renal failure.
作者信息
Kose Adem, Yakupogullari Yusuf
机构信息
Manavgat State Hospital, Infectious Diseases and Clinical Microbiology Clinic, Manavgat, Antalya, Turkey.
Medical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey.
出版信息
Jundishapur J Microbiol. 2015 Jan 14;8(3):e19980. doi: 10.5812/jjm.19980. eCollection 2015 Mar.
INTRODUCTION
Listeria monocytogenes is a significant zoonosis causing invasive infections in the susceptible persons. The current paper presented a patient who died due to a rapidly-progressing multiple organ failure (MOF) as a result of severe sepsis caused by L. monocytogenes.
CASE PRESENTATION
A 70-years-old patient with chronic renal failure was admitted to the infectious diseases clinic due to diarrhea for one day. He was hospitalized and the body fluid samples were collected for laboratory analyses. Within few hours, his vital findings worsened, and he developed respiratory arrest. Ceftriaxone and gentamycin were administrated. However, he died due to disseminated intravascular coagulation, septic shock and meningoencephalitis at the 22nd hour of admission. Causative agent was identified as L. monocytogenes serotype-4b in post-mortem period.
DISCUSSION
L. monocytogenes can cause progressive and rapidly fatal infections in the vulnerable persons, with multisystem involvement. Since this bacterium is not susceptible to cephalosporines, it will be better to consider effective antimicrobials in the treatment of the possible cases.
引言
单核细胞增生李斯特菌是一种重要的人畜共患病原体，可在易感人群中引起侵袭性感染。本文介绍了一名因单核细胞增生李斯特菌引起的严重脓毒症导致快速进展的多器官功能衰竭（MOF）而死亡的患者。
病例报告
一名70岁的慢性肾衰竭患者因腹泻一天入住传染病诊所。他住院并采集了体液样本进行实验室分析。数小时内，他的生命体征恶化，并出现呼吸骤停。给予了头孢曲松和庆大霉素治疗。然而，他在入院第22小时因弥散性血管内凝血、感染性休克和脑膜脑炎死亡。死后鉴定病原体为4b型单核细胞增生李斯特菌。
讨论
单核细胞增生李斯特菌可在易感人群中引起进行性且迅速致命的感染，并累及多系统。由于该细菌对头孢菌素不敏感，因此在治疗可能的病例时最好考虑使用有效的抗菌药物。
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