Long S G, Leyland M J, Milligan D W
Department of Haematology, Birmingham Heartlands Hospital, UK.
Bone Marrow Transplant. 1993 Nov;12(5):537-9.
Over the past decade infections from food-borne Listeria monocytogenes have become an important cause of septicaemia and meningitis and immunocompromised patients are at particular risk. We report three cases of Listeria meningitis occurring post-BMT. The patients were aged 53, 51 and 56 years and presented 4, 7 and 90 months post-transplant, respectively. The first patient had undergone allogeneic BMT for myelodysplasia and the other two patients had ABMT for AML in second and first CR, respectively. All the patients presented with classical features of meningitis and L. monocytogenes was cultured from cerebrospinal fluid. All made a full recovery with appropriate antibiotic therapy. We have not seen cases of meningitis due to other organisms in our transplant programme and the cases represent a risk of one episode per 59 surviving patient years. None of the patients was receiving prophylactic post-BMT antibiotics and the episodes may strengthen the case for using prophylactic penicillin. Recent epidemics of septicaemia and meningitis caused by L. monocytogenes-contaminated milk and cheese suggest that these patients should be informed about potential sources of infection.
在过去十年中，食源性单核细胞增生李斯特菌感染已成为败血症和脑膜炎的一个重要病因，免疫功能低下的患者尤其危险。我们报告了3例异基因骨髓移植（BMT）后发生的李斯特菌脑膜炎病例。患者年龄分别为53岁、51岁和56岁，分别在移植后4个月、7个月和90个月发病。首例患者因骨髓增生异常综合征接受了异基因BMT，另外两名患者分别在第二次和第一次完全缓解（CR）时因急性髓细胞白血病（AML）接受了自体骨髓移植（ABMT）。所有患者均表现出脑膜炎的典型症状，且脑脊液培养出单核细胞增生李斯特菌。经适当的抗生素治疗后，所有患者均完全康复。在我们的移植项目中，尚未见过由其他病原体引起的脑膜炎病例，这些病例代表着每59个存活患者年中有1例发病的风险。所有患者在BMT后均未接受预防性抗生素治疗，这些病例可能会加强使用预防性青霉素的理由。近期由受单核细胞增生李斯特菌污染的牛奶和奶酪引起的败血症和脑膜炎疫情表明，应告知这些患者潜在的感染源。
