Ferguson R, Yee S, Finkle H, Rose T, Schneider V, Gee G
Department of Medicine, Highland General Hospital, Oakland, California 94602-1098.
J Natl Med Assoc. 1993 Mar;85(3):225-8.
Listeria monocytogenes is a pathogenic, facultative intracellular gram-positive rod, generally seen in cell-mediated immunocompromised states. In acquired immunodeficiency syndrome (AIDS), it most commonly presents as bacteremia or meningitis. An association with pericarditis has not been described previously in this group of patients. This article describes a case of pericarditis secondary to listeriosis involving a focal pancarditis and necrosis of the A-V node with subsequent refractory ventricular tachyarrhythmias in an immunodeficient patient presenting with altered mental status. Infectious etiologies should be considered for "benign" appearing pericardial effusions in AIDS patients and the diagnosis of listeriosis excluded in the presence of "diphtheroid-like" organisms.
单核细胞增生李斯特菌是一种致病性兼性细胞内革兰氏阳性杆菌,通常见于细胞介导的免疫功能低下状态。在获得性免疫缺陷综合征(AIDS)中,它最常表现为菌血症或脑膜炎。此前尚未有该组患者发生心包炎的相关描述。本文报道了一例免疫功能低下且意识状态改变的患者,其因李斯特菌病继发心包炎,表现为局灶性全心肌炎和房室结坏死,随后出现难治性室性快速心律失常。对于AIDS患者中看似“良性”的心包积液,应考虑感染性病因,且在存在“类白喉样”微生物时应排除李斯特菌病的诊断。