基础医学与临床 ›› 2019, Vol. 39 ›› Issue (7): 1036-1039.

• 临床研究 • 上一篇    下一篇

成人中枢神经系统李斯特菌感染患者的临床特征

范张玲1,甘沛1,谢静2,王焕玲1   

  1. 1. 中国医学科学院北京协和医学院北京协和医院
    2. 中国医学科学院北京协和医学院 北京协和医院感染内科
  • 收稿日期:2019-04-12 修回日期:2019-05-21 出版日期:2019-07-05 发布日期:2019-07-02
  • 通讯作者: 王焕玲 E-mail:wanghuanling@pumch.cn
  • 基金资助:
    国家重点研发计划课题

Clinical features of adult patients with central nervous system Listeria monocytogenes infection

  • Received:2019-04-12 Revised:2019-05-21 Online:2019-07-05 Published:2019-07-02

摘要: 目的 分析成人中枢神经系统李斯特菌感染的临床特点、治疗转归,提高对中枢神经系统李斯特菌病的认识。方法 回顾性分析北京协和医院1999年至2018年收治的成人中枢神经系统李斯特菌病患者的临床特征。结果 共纳入34例成人中枢神经系统李斯特菌感染患者,女性占68%,平均年龄为(43±15)岁;32例(94%)患者有基础疾病;临床表现主要为发热(100%),意识改变(71%);实验室检查发现外周血白细胞和中性粒细胞计数均升高,淋巴细胞计数减少;C反应蛋白升高(85%); 9例(26%)患者临床转归不佳,2例死亡,7例病重转院/出院。结论 成人中枢神经系统李斯特菌病多累及原有免疫低下疾病患者,临床预后不良转归机率高,当免疫功能低下患者出现中枢神经系统感染症状时,应考虑到李斯特菌病,抗菌素经验用药应覆盖李斯特菌。

关键词: 中枢神经系统感染, 李斯特菌病, 成人

Abstract: Objective To better understand the clinical characteristics of central nervous system Listeriosis. Methods The clinical data of adult patients with CNS Listeriosis admitted to PUMCH from 1999 to 2018 were collected. The clinical features were retrospectively analyzed. Results A total of 34 adult patients with CNS Listeriosis were enrolled in this study. The average age of all patients was (43±15) years, from which female patients took 68%. 94% patients had at least one underlying disease. All patients had fever, and 71% of patients appeared altered consciousness. Peripheral blood leukocytes and neutrophils were significantly increased while the level of lymphocytes was decreased; 85% of those patients had elevated C-reactive protein levels. 26% had poor clinical outcomes. Conclusions Adult patients with CNS Listeriosis are often associated with autoimmune diseases, and the clinical manifestation usually turned to be heavier. When patients have symptoms of central nervous system infection, we should consider Listeriosis, and empirical medication should cover Listeria.

Key words: Central nervous system infection, Listeriosis, Adult