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病例报告:一例来自老挝人民民主共和国的阑尾炎后播散性皮肤李斯特菌病病例。

Case Report: A case of disseminated cutaneous listeriosis following appendicitis from Lao PDR.

作者信息

Evans Terry John, Siratana Vannavong, Venkatesan Timothy, Davong Viengmon, Thanadabouth Khamphong, Ashley Elizabeth A

机构信息

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Lao People's Democratic Republic.

London School of Hygiene and Tropical Medicine, London, UK.

出版信息

Wellcome Open Res. 2024 May 15;8:504. doi: 10.12688/wellcomeopenres.20210.1. eCollection 2023.

Abstract

BACKGROUND

is a food-borne pathogen that is a rare cause of bacteraemia and meningitis in immunosuppressed patients, and carries a high mortality rate. Cutaneous manifestations of listeriosis are rare, and are usually associated with direct inoculation of the skin.

CASE

A 41-year-old woman who initially presented to a hospital in Laos with appendicitis was diagnosed with disseminated listeriosis with cutaneous involvement. Intra-abdominal pathology probably contributed to bacterial bloodstream invasion. Initial treatment with meropenem was switched to ampicillin based on best practice, however our patient died 5 days after diagnosis.

CONCLUSIONS

This case highlights listeriosis as an important cause of mortality in low- and middle-income countries, exacerbated by poor availability of laboratory diagnostics and ineffective empiric antibiotic regimens. Improvements in food hygiene, surveillance, and increased laboratory capacity are important strategies to reduce rates of infection and clinical outcomes.

摘要

背景

是一种食源性病原体,在免疫抑制患者中是菌血症和脑膜炎的罕见病因,且死亡率很高。李斯特菌病的皮肤表现罕见,通常与皮肤直接接种有关。

病例

一名41岁女性最初因阑尾炎就诊于老挝一家医院,被诊断为播散性李斯特菌病并累及皮肤。腹腔内病变可能导致细菌侵入血流。根据最佳实践,最初用美罗培南治疗改为氨苄西林治疗,但我们的患者在诊断后5天死亡。

结论

该病例凸显了李斯特菌病在低收入和中等收入国家是重要的死亡原因,而实验室诊断手段匮乏和经验性抗生素治疗方案无效使情况更加恶化。改善食品卫生、监测以及提高实验室能力是降低感染率和改善临床结局的重要策略。

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