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使用乌司奴单抗治疗的肝硬化和原发性硬化性胆管炎患者侵袭性单核细胞增生李斯特菌感染的快速进展

Rapid Progression of Invasive Listeria monocytogenes Infection in a Patient With Cirrhosis and Primary Sclerosing Cholangitis on Ustekinumab.

作者信息

Budvytyte Laura, Schroeder Mariah, Graf Erin, Vaillant James J

机构信息

Department of Laboratory Medicine and Pathology, Mayo Clinic Alix School of Medicine, Scottsdale, USA.

Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, USA.

出版信息

Cureus. 2024 Apr 12;16(4):e58116. doi: 10.7759/cureus.58116. eCollection 2024 Apr.

DOI:10.7759/cureus.58116
PMID:38738136
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11088815/
Abstract

We present the case of a 62-year-old immunocompromised man with ulcerative colitis, primary sclerosing cholangitis, and cirrhosis treated with azathioprine and ustekinumab who quickly developed invasive infection after incidental identification on routine paracentesis. The infection rapidly progressed from bacterial peritonitis to bacteremia and meningitis within three days. Treatment with ampicillin and trimethoprim/sulfamethoxazole was successful. We highlight the increased risk of invasive listeriosis in immunocompromised individuals, including those on biologic therapies, and the importance of considering as a pathogen from sterile sites even in asymptomatic patients.

摘要

我们报告了一例62岁免疫功能低下的男性病例，该患者患有溃疡性结肠炎、原发性硬化性胆管炎和肝硬化，接受硫唑嘌呤和乌司奴单抗治疗，在常规腹腔穿刺偶然发现后迅速发生侵袭性感染。感染在三天内迅速从细菌性腹膜炎发展为菌血症和脑膜炎。氨苄西林和甲氧苄啶/磺胺甲恶唑治疗成功。我们强调免疫功能低下个体，包括接受生物疗法的个体，发生侵袭性李斯特菌病的风险增加，以及即使在无症状患者中，也应将其视为来自无菌部位的病原体的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24bb/11088815/85cad270a02f/cureus-0016-00000058116-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24bb/11088815/85cad270a02f/cureus-0016-00000058116-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24bb/11088815/85cad270a02f/cureus-0016-00000058116-i01.jpg

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