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[新生儿李斯特菌病。关于53例病例]

[Neonatal listeriosis. Apropos of 53 cases].

作者信息

Relier J P, Amiel-Tison C, Krauel J, Helffer L, Larroche J C, Minkowski A

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1977 Apr-May;6(3):367-81.

PMID:903579
Abstract

53 cases of neonatal listeriosis were seen during the last five years at the Intensive Care Unit for newborn infants (Pr Minkowski) and the Neonatal Center (P. Varangot) of the Port-Royal Maternity Hospital. The significant decline in mortality to 22 p. 100, when compared with previous years, was attributed to improvements in the diagnosis during the first hours of life and the contribution of artificial ventilation. The most frequent initial clinical sign was respiratory distress (58 p. 100) whereas meningitis was relatively rare (11 p. 100). Discoloration of the amniotic fluid and a fever in the mother at the time of delivery, were also important diagnostic clues. The macroscopic examination of the placenta and particularly placental smears containing listeria monocytogenes (15 of the specimens) as well as the hematological alterations, particularly an increase of the fibrinogen level above 3-4 g/1 during the first 48 hous of life (72 p. 100 of the cases) contributed to an early diagnosis.

摘要

在过去五年间,皇家妇产医院新生儿重症监护病房(由明科夫斯基医生负责)和新生儿中心(由瓦朗戈医生负责)共收治了53例新生儿李斯特菌病患者。与前些年相比,死亡率显著下降至22%,这归因于出生后最初几小时诊断水平的提高以及人工通气的作用。最常见的初始临床症状是呼吸窘迫(58%),而脑膜炎相对少见(11%)。羊水变色以及母亲分娩时发热也是重要的诊断线索。胎盘的宏观检查,特别是发现含有产单核细胞李斯特菌的胎盘涂片(15份标本)以及血液学改变,尤其是出生后头48小时内纤维蛋白原水平升高至3 - 4克/升以上(72%的病例),有助于早期诊断。

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