This is the 3562nd article of Da Yi Xiao Nursing
Aunt Li in recent days repeated fever, headache, nausea, vomiting, and even unconscious, was diagnosed as meningitis, after careful questioning by the doctor and various examinations, it was finally determined to be Listeria infection, the reason is that Aunt Li drank the milk that had been opened in the refrigerator. Many people are unfamiliar with listeria infection, and today we will take a look at it together.
1. What is Listeria?
Listeria monocytogenes , also known as Listeria monocytogenes , is a facultative anaerobic bacterium that is a pathogen of listeria infection. It is mainly food-borne as a vector, one of the deadliest foodborne pathogens, unlike other bacteria, Listeria is not afraid of cold, can survive in 3-45 degrees. Therefore, Listeria also has a nickname called "refrigerator killer", which mainly contaminates raw milk, cheese, meat and meat products, eggs, vegetable salads, seafood, ready-to-eat foods and so on.
Listeria infection is rare in the general population, and occurs mostly in newborns, pregnant women, the elderly, organ transplant recipients and other immune transplante people, which can lead to neonatal sepsis, miscarriage, premature birth, meningitis, bloodstream infection, etc., and can also lead to self-limited gastroenteritis with fever. If an immunocompromised person develops a listeria infection, the condition is severe, with a case fatality rate of up to 33%.
Second, the characteristics
1. Widely distributed
It exists in soil, water (surface water, sewage, wastewater), plants, vegetables, etc.
2. The living environment is highly malleable
It can survive at 3-45 ° C and can grow and multiply in refrigerators and refrigerators for a long time.
3. Foods with higher bacteria are available
Milk and dairy products, meat (especially beef), vegetables, salads, seafood, ice cream, etc.
3. Clinical manifestations
1. Meningitis is the most common manifestation of the disease. Adult patients often present with high fever, headache, nausea, vomiting, neck rigidity, coma, and predominantly granulocytes with elevated white blood cells. Newborns can become infected during or after childbirth and become ill 1 to 3 weeks postpartum, mainly manifesting as food refusal, crying, hyperthermia, convulsions, fontanelle herniation, and meningeal irritation. Most people with meningitis have a bloodstream infection at the same time, and some patients may have a brain abscess.
2. After the fetus is infected with this bacterium through the placenta, miscarriage and fetal death can occur intrauterine.
3. Patients with lymph node infection may have sudden fever, headache, sore throat, cervical and systemic lymphadenopathy, hepatosplenomegaly, increased white blood cells, and mononucleosis of varying degrees.
4. Self-limiting gastroenteritis is mostly manifested as fever with watery diarrhea, fatigue, myalgia and other general discomfort, more than the intake of contaminated food for about 24 hours, the symptoms last for about 1-3 days can gradually heal on their own. Infection with endocardium, liver, gallbladder, muscles and other organ tissues may have corresponding manifestations.
4. Diagnosis and treatment
The diagnosis of this disease relies on etiological basis, and listeria can be diagnosed by obtaining sterile specimen cultures through blood culture, lumbar puncture, etc., and the recent second-generation sequencing technology (NGS) has also played an important role in the diagnosis of patients with negative sample cultures. A variety of antibacterial drugs have an antibacterial effect on Listeria, but the first choice of ampicillin, penicillin allergy patients can choose macrolides, sulfonamides, vancomycin and other drugs according to the site of infection, meropenem has antibiotics in vitro, and it should be noted that cephalosporin antibiotics are resistant to this bacterium. The general course of treatment is not less than 2 weeks, and the course of treatment for meningitis patients is more than 3 weeks.
Fifth, prevention
Listeria can be killed after heating to 60-70 ° C for 5-20 minutes, and it can also be killed for 5 minutes using 70% alcohol. Therefore, the main focus on prevention is to deal with listeria: usually stay away from high-risk foods, such as leftovers, unpasteurized cheese, long-term refrigeration of food fruits and vegetables. At the same time, it is necessary to develop good habits, wash your hands carefully, separate raw and cooked, and fully heat food before eating.
Author: Department of Emergency Medicine, Second Affiliated Hospital of Xi'an Jiaotong University
Pei Honghong Chief Physician Guidance
Department of Emergency Medicine, Second Affiliated Hospital of Xi'an Jiaotong University
Written by Dang Pei Nurse