Liang Jing-Jing, He Xiao-Yan, Ye Hong
Department of Neurology, Wuhan University, Renmin Hospital, Wuhan 430060, Hubei Province, China.
Department of Neurology, Shijiazhuang Second Hospital, Shijiazhuang 050200, Hebei Province, China.
World J Clin Cases. 2019 Feb 26;7(4):538-547. doi: 10.12998/wjcc.v7.i4.538.
(), a Gram-positive facultatively intracellular bacterium, is the causative agent of human listeriosis. infection is usually found in immunocompromised patients, including elderly people, pregnant women, and newborns, whereas it is rare in healthy people. may cause meningitis, meningoencephalitis, and some very rare and severe complications, such as hydrocephalus and intracranial hemorrhage, which cause high mortality and morbidity worldwide. Up to now, reports on hydrocephalus and intracranial hemorrhage due to are few.
We herein report a case of rhombencephalitis caused by . in a 29-year-old man. He was admitted to the hospital with a 2-d history of headache and fever. He consumed unpasteurized cooked beef two days before appearance. His medical history included type 2 diabetes mellitus, and contaminated beef intake 2 d before onset. Cerebrospinal fluid analysis revealed Gram-positive rod infection, and blood culture was positive for . . Magnetic resonance imaging findings suggested rhombencephalitis and hydrocephalus. Treatment was started empirically and then modified according to the blood culture results. Repeated CT images were suggestive of intracranial hemorrhage. Although the patient underwent aggressive external ventricular drainage, he died of a continuing deterioration of intracranial conditions.
Hydrocephalus, intracranial hemorrhage, and inappropriate antimicrobial treatment are the determinations of unfavorable outcomes.
[细菌名称]是一种革兰氏阳性兼性胞内细菌，是人类李斯特菌病的病原体。该细菌感染通常见于免疫功能低下的患者，包括老年人、孕妇和新生儿，而在健康人群中较为罕见。它可能导致脑膜炎、脑膜脑炎以及一些非常罕见且严重的并发症，如脑积水和颅内出血，这些并发症在全球范围内导致高死亡率和高发病率。到目前为止，关于[细菌名称]所致脑积水和颅内出血的报道很少。
我们在此报告一例由[细菌名称]引起的一名29岁男性的菱形脑炎病例。他因头痛和发热2天入院。发病前两天他食用了未经巴氏消毒的熟牛肉。他有2型糖尿病病史，发病前2天摄入了受污染的牛肉。脑脊液分析显示革兰氏阳性杆菌感染，血培养[细菌名称]呈阳性。磁共振成像结果提示菱形脑炎和脑积水。开始进行经验性治疗，然后根据血培养结果进行调整。重复的CT图像提示颅内出血。尽管患者接受了积极的外部脑室引流，但最终因颅内情况持续恶化而死亡。
脑积水、颅内出血以及不恰当的抗菌治疗是不良预后的决定因素。
