儿童单核细胞增多性李斯特菌脑膜炎1例报告

Listeria monocytogenes meningitis in a child:a case report

目的总结单核细胞增多性李斯特菌(LM)脑膜炎患儿的临床特点及治疗转归。方法回顾性分析1例诊断为LM脑膜炎患儿的临床资料,并查阅文献。结果本例患儿以发热、头痛、呕吐起病,经阿莫西林/克拉维酸钾及头孢曲松抗感染治疗有效,脑脊液及血培养均为LM生长。查阅到17篇相关文献,共24例患儿,其中4例死亡,10例发生脑积水等,氨苄西林或联合使用氨基糖苷类抗生素治疗有效。结论 LM脑膜炎在免疫功能正常儿童发生率低,但病死率及后遗症发生率高。脑脊液和血培养有助于诊断。

Objective The clinical characteristics and treatment outcomes of Listeria monocytogenes （LM） meningitis were reviewed. Methods The clinical data of a case of LM meningitis were retrospectively analyzed and a literature review was performed. Results The child initially presenting with fever, headache and vomit was treated with amoxicillin/clavulanic acid and ceflriaxone and the treatment effect was obvious. Cerebrospinal fluid and blood cultures were LM positive. In 17 related arti- cles, a total of 24 children with LM meningitis were reviewed. Among them, 4 patients died and 10 had hydrocephalus. The treatment with either ampicillin alone or in combination with aminoglycoside was effective. Conclusions LM meningitis was rare in immunocompetent children, but has high rates of mortality and sequelae.