Pérez Roldán F, Bañares R, Piqueras B, De Diego A, Castellote I, Casado M, García F J, Cos E, Clemente G
Servicio de Aparato Digestivo, Hospital Gral, Universitario Gregorio Marañón, Madrid.
Rev Esp Enferm Dig. 1995 Dec;87(12):889-92.
Listeria monocytogenes is a gram-positive coccobacillus that produces infections in both the normal and the compromised host. Symptomatic bacteremia and pulmonary infection or meningitis are the most common clinical presentations in adults. According to a current review of the literature, Listeria is a rare bacteria that may produce spontaneous bacterial peritonitis (23 cases reported). Listeria peritonitis occurs in more than two-thirds of the cases in patients with chronic liver disease, but may also occur in patients with malignancy or undergoing peritoneal dialysis. We describe two cases of SBP in cirrhotic patients, one with alcoholic cirrhosis and other due to HCV infection. One patient also presented with acute meningitis. Peritonitis due to Listeria was clinically and analytically similar to any SBP. Third-generation cephalosporins commonly used in the therapy of SBP, are ineffective in this infection. Ampicillin is the drug of choice, although it should be used in combination therapy usually with an aminoglycoside. The mortality from Listeria peritonitis is similar to that of other SBP (17%).
单核细胞增生李斯特菌是一种革兰氏阳性球杆菌，可在正常宿主和免疫功能低下的宿主中引发感染。有症状的菌血症、肺部感染或脑膜炎是成人中最常见的临床表现。根据当前的文献综述，李斯特菌是一种罕见的细菌，可引发自发性细菌性腹膜炎（已报道23例）。李斯特菌性腹膜炎在超过三分之二的慢性肝病患者中发生，但也可能发生在恶性肿瘤患者或接受腹膜透析的患者中。我们描述了两例肝硬化患者的自发性细菌性腹膜炎病例，一例为酒精性肝硬化，另一例为丙型肝炎病毒感染所致。一名患者还出现了急性脑膜炎。李斯特菌引起的腹膜炎在临床和分析上与任何自发性细菌性腹膜炎相似。常用于治疗自发性细菌性腹膜炎的第三代头孢菌素对这种感染无效。氨苄西林是首选药物，不过通常应与氨基糖苷类药物联合使用。李斯特菌性腹膜炎的死亡率与其他自发性细菌性腹膜炎相似（17%）。
