免疫功能正常的儿童产单核细胞李斯特菌脑膜炎3例并文献复习

Listeria monocytogenes meningitis in three immunocompetent children and a review of the literature

目的:总结3例免疫功能正常儿童产单核李斯特菌(Listeria monocytogenes,Lm)脑膜炎的临床特征和抗生素治疗效果,提高对该疾病的认知。方法:回顾性分析2016年1月~2019年5月浙江大学医学院附属儿童医院收治的3例免疫功能正常的儿童李斯特菌脑膜炎患儿的临床特征和治疗方案,并进行相关文献复习,对比分析国内儿童Lm脑膜炎病例报道中抗生素使用情况。结果:患儿均有发热、呕吐等症状,脑脊液细胞学为典型化脓性脑膜炎表现,治疗上对头孢类药物不敏感,氨苄西林仍然作为首选药,美罗培南和利奈唑胺可作为临床选择用药。结论:对于脑膜炎患儿,经验性抗感染治疗无效时,需考虑Lm脑膜炎的可能,及时开展可有效覆盖李斯特菌的抗生素治疗。

Objective:To summarize the clinical characteristics and treatment outcome of 3 cases of Listeria monocytogenes(Lm)meningitis in immunocompetent children so as to improve clinicians'awareness of the disease.Methods:The clinical features and treatment of Lm meningitis in children admitted to Children's Hospital of Zhejiang University School of Medicine from January 2016 to May 2019 were analyzed retrospectively.The study summarized related literatures,and compared the selection of antibiotics in children with Lm meningitis reported in cases.Results:All patients had typical purulent meningitis syndromes inlcluding fever,vomiting,CSF and other symptoms;Ampicillin is currently the first choice of treatment,while meropenem and Linezolid could be administered as alternative drugs for Lm meningitis.Conclusion:sFor children with meningitis,when the empirical antibiotics treatment failed to be effective,the possibility of Lm meningitis should be considered,and antibiotics that can effectively cover Lm should be adjusted in time.