妊娠晚期孕妇感染产单核李斯特菌致胎死宫内2例报告并文献回顾

Analysis on two cases of fetal death caused by maternal Listeria monocytogenes infection in late trimester of pregnancy and literature review

目的分析围生期孕妇感染产单核李斯特菌病的临床特征,治疗和愈后情况,以提高临床工作中对该病的认识和重视程度。方法选取2017年4月—5月2例确诊产单核李斯特菌感染的产前发热患者,对其临床资料进行分析,包括发病情况、临床表现、实验室指标、病情严重程度、治疗情况及母婴结局等,并结合相关文献对围生期孕妇李斯特菌病的临床特点进行探讨。结果 2例孕妇均诊断为产单核李斯特菌感染合并菌血症,出现胎死宫内现象,娩出无生机儿。结论李斯特菌很容易感染免疫力相对低下的孕产妇,并通过垂直传播引起宫内感染,易致不良妊娠结局。应提高对妊娠期妇女感染李斯特菌病的警惕性,以期做到早发现、早诊断、早治疗,改善围生儿生存结局。

Objective To enhance awareness and attention through demonstrating clinical characteristics of Listeria monocytogenes infection during pregnancy as well as its treatment and prognoses. Methods A retrospective study of two listeriosis cases who were treated in Tongji Hospital of Tongji University was conducted.Patients’ main complains,clinical features,laboratory examinations,severity of the disease,treatment,and maternal and infant outcomes were studied.The clinical characteristics of listeriosis in perinatal pregnant women were discussed based on relevant literature. Results These 2 mothers were diagnosed with Listeria monocytogenes infection combined with bacteremia.Both cases ended in bacteremia and intrauterine fetal death. Conclusion Listeriosis easily infects pregnant women with relatively low immunity and causes intrauterine infection through vertical transmission,resulting in adverse pregnancy outcomes.We should improve practioners’ vigilance for pregnant women infected with Listeria monocytogenes so as to achieve early detection,early diagnosis,and early treatment,and improve perinatal survival.