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腹膜炎作为腹膜透析患者播散性李斯特菌病的首发表现——病例报告

Peritonitis as the First Presentation of Disseminated Listeriosis in a Patient on Peritoneal Dialysis-a Case Report.

作者信息

Beckerleg Weiwei, Keskar Vaibhav, Karpinski Jolanta

机构信息

Department of Medicine, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada

Department of Medicine, The Ottawa Hospital, Affiliated with the University of Ottawa Faculty of Medicine, Ottawa, ON, Canada.

出版信息

Perit Dial Int. 2017 Mar-Apr;37(2):239-240. doi: 10.3747/pdi.2016.00205.

Abstract

Infections with are uncommon but serious, with mortality rate approaching 30% in cases of systemic involvement despite first-line therapy. They are usually caused by ingestion of contaminated foods, but spontaneous infections have also been described. is a rare cause of peritonitis, and most of the published cases are in patients with cirrhosis and ascites. There are a few reported cases of peritonitis associated with peritoneal dialysis (PD), primarily isolated peritonitis.If detected early, peritonitis can be successfully treated with ampicillin, alone or in combination with gentamicin. Vancomycin has been listed as a second-line agent. However, it has been associated with treatment failure.In this case report, we present a patient who developed disseminated listeriosis, with peritonitis as the first manifestation of disseminated infection. This case illustrates the importance of having a high index of suspicion for if patients deteriorate despite empiric therapy for PD-associated peritonitis and serves as a further example demonstrating the inadequate coverage of vancomycin for .

摘要

[病原体名称]感染虽不常见但很严重,尽管采用一线治疗,全身感染病例的死亡率仍接近30%。通常由摄入受污染食物引起,但也有自发性感染的报道。[病原体名称]是腹膜炎的罕见病因,大多数已发表病例见于肝硬化和腹水患者。有少数关于[病原体名称]腹膜炎与腹膜透析(PD)相关的报道病例,主要是孤立性腹膜炎。如果早期检测到,[病原体名称]腹膜炎可用氨苄西林单独或联合庆大霉素成功治疗。万古霉素已被列为二线药物。然而,它与治疗失败有关。在本病例报告中,我们介绍了一名发生播散性李斯特菌病的患者,腹膜炎是播散性感染的首发表现。该病例说明了如果患者在接受与PD相关腹膜炎的经验性治疗后仍病情恶化,对[病原体名称]保持高度怀疑的重要性,并进一步证明了万古霉素对[病原体名称]的覆盖不足。

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