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由并发溃疡性结肠炎的李斯特菌肠炎引起的单核细胞增生李斯特菌败血症和脑膜炎

Listeria Monocytogenes Septicemia and Meningitis Caused by Listeria Enteritis Complicating Ulcerative Colitis.

作者信息

Inoue Takahiro, Itani Toshinao, Inomata Noriko, Hara Kazuya, Takimoto Ikuhisa, Iseki Shunya, Hamada Kensuke, Adachi Kanna, Okuyama Shunsuke, Shimada Yukari, Hayashi Motohito, Mimura Jun

机构信息

Department of Gastroenterology, Nishi-Kobe Medical Center, Japan.

出版信息

Intern Med. 2017 Oct 1;56(19):2655-2659. doi: 10.2169/internalmedicine.8654-16. Epub 2017 Sep 6.

Abstract

An 80-year-old man, who had been diagnosed with ulcerative colitis, was admitted due to a fever and bloody diarrhea and was treated with a glucocorticoid and azathioprine. After 5 days, he developed an impaired consciousness, headache, and neck stiffness. A sample of the colonic mucosa, blood cultures, and cerebrospinal fluid revealed Listeria monocytogenes infection. Intravenous ampicillin improved the symptoms of fever, bloody diarrhea, and headache without any neurological sequelae. Physicians should consider that Listeria enteritis complicating ulcerative colitis can cause septicemia and meningitis in immunosuppressed patients. A patient's central nervous system can avoid the effects of Listeria meningitis by an early diagnosis and appropriate treatment.

摘要

一名80岁男性,此前被诊断为溃疡性结肠炎,因发热和血性腹泻入院,接受糖皮质激素和硫唑嘌呤治疗。5天后,他出现意识障碍、头痛和颈部僵硬。结肠黏膜样本、血培养和脑脊液检查显示感染了单核细胞增生李斯特菌。静脉注射氨苄青霉素改善了发热、血性腹泻和头痛症状,且未留下任何神经后遗症。医生应考虑溃疡性结肠炎合并李斯特菌肠炎可在免疫抑制患者中引起败血症和脑膜炎。通过早期诊断和适当治疗,患者的中枢神经系统可避免李斯特菌脑膜炎的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6545/5658535/dd17132aa239/1349-7235-56-2655-g001.jpg

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