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在两年的时间里,反复发作、与 ICD 相关的单核细胞增生李斯特菌菌血症,伴有多处感染性肺栓塞。

Recurrent, ICD-associated L. monocytogenes bacteraemia with multiple septic pulmonary embolisms over a 2-year period.

机构信息

National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria.

Paracelsus Medical University Salzburg, Salzburg, Austria.

出版信息

Infection. 2024 Aug;52(4):1615-1620. doi: 10.1007/s15010-024-02209-w. Epub 2024 Mar 6.

Abstract

BACKGROUND

Listeria monocytogenes is a bacterial pathogen known for causing listeriosis, a foodborne illness with a wide spectrum of clinical presentations ranging from mild gastroenteritis to severe invasive disease, particularly affecting immunocompromised individuals, pregnant women, newborns, and the elderly. Successful treatment of patients with recurring listeria episodes due to colonised foreign material is often challenging, typically requiring a combination of antimicrobial treatment and surgical removal.

CASE PRESENTATION

Here, we present a particularly complex case of chronic invasive listeriosis with a total of six relapses. After extensive investigations, the patient's ICD device was identified as the focus of infection.

CONCLUSION

The confirmation of relapses through cgMLST analysis highlights the persistence of Listeria monocytogenes and the potential for recurrence even after apparent resolution of symptoms in patients with foreign material. It emphasises the necessity for a comprehensive assessment to identify and mitigate the risk of relapses, thereby ensuring optimal management and outcomes.

摘要

背景

单核细胞增生李斯特菌是一种细菌病原体,可引起李斯特菌病,这是一种食源性疾病,临床表现广泛,从轻度胃肠炎到严重侵袭性疾病不等,尤其影响免疫功能低下者、孕妇、新生儿和老年人。对于因定植异物而反复发生李斯特菌感染的患者,成功治疗往往具有挑战性,通常需要联合使用抗菌治疗和手术切除。

病例介绍

这里,我们介绍了一例特别复杂的慢性侵袭性李斯特菌病,共发生了 6 次复发。经过广泛的调查,发现患者的 ICD 设备是感染的焦点。

结论

通过 cgMLST 分析确认复发突显了李斯特菌的持续存在,以及即使在有异物的患者症状明显缓解后仍有复发的可能性。它强调了需要进行全面评估以识别和降低复发风险,从而确保最佳的管理和结果。

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