1例单增李斯特菌误诊病例分析并文献复习

目的 探讨1 例单增李斯特菌病的诊疗过程及误诊原因,降低误诊率。方法 回顾性分析先后误诊为视神经脊髓炎、病毒性脑膜炎的单增李斯特菌脑膜炎患者的诊疗过程及误诊原因。结果 患者主要表现为肢体麻木、乏力、反复发热、意识障碍、言语不清等。单增李斯特菌性脑膜炎累及脊髓患者临床表现具有误导性。患者经青霉素联合复方磺胺甲噁唑治疗好转出院,遗留神经系统后遗症。结论 临床医生应提高对单增李斯特菌感染疾病的警惕性,加强对相关知识的了解,提高诊治水平,避免误诊误治。

Case of Listeria monocytogenes meningitidis:controversial issues for the diagnosis and literature review

To explore the procedures of Listeria monocytogenes meningitidis, and analyze the causes of misdiagnosis so as to reduce the rate of misdiagnosis. The diagnosis and treatment and cause of Listeria monocytogenes meningitidis who was misdiagnosed as neuromyelitis optical and viral meningitidis were retrospectively analyzed and reviewed relevant literatures. The results showed that the main symptoms of the patient was numbness and weakness of limbs,repeated fever, changes in the content of consciousness, irrational speech,etc. The clinical of listeria monocytogenes meningitis involving the spinal cord is misleading.The patient got better and discharged from the hospital after the treatment of penicillin combined with sulfamethoxazole/trimethoprim,however, the neurological sequelae hangover was left. In conclusion, the clinical doctors should enhance the vigilance of the Listeria monocytogenes meningitidis septicemia syndrome, strengthen the understanding of relevant knowledge for improving diagnosis and treatment, and reducing misdiagnosis and mistreatment.