Ölümün kıyısından dönen gebe listeria rombensefaliti olgusu

Abstract

Listeria monocytogenes, fekal-oral yolla bulaşan zoonotik bir enfeksiyon etkeni olup, gebelerde, 50 yaş üzeri hastalarda, immün yetmezlikli hastalarda ve alkolik hastalarda menenjit, ensefalit, meningoensefalit ve rombensefalit gibi santral sinir sistemi enfeksiyonlarına neden olabilir. Gebelik, Listeria monocytogenes enfeksiyonları için önemli bir predispozan durumdur ve gebelerde enfeksiyon ağır seyredebilir. Bu yazıda, 3 gündür ateş, baş ağrısı, baş dönmesi, bulantı, kusma yakınmaları ile başvuran ve hiperemezis gravidarum ön tanısıyla kadın hastalıkları ve doğum kliniğine yatırılan, Listeria monocytogenes ’e bağlı olarak gelişen rombensefalit tanısı konulan 28 yaşında 8 haftalık gebe kadın hasta sunuldu. Hastanın tanısı, klinik bulgularla birlikte kan kültüründen etkenin izole edilmesi ve manyetik rezonans görüntülemede rombensefalit saptanması ile konuldu. Gebeliği medikal abortusla sonlandırılan hastaya antimikrobiyal tedavi toplam 6 ay süreyle uygulandı, tedavi bitiminde klinik bulguları ve manyetik rezonans görüntülemede saptanan lezyonları tamamen düzeldi.

Keywords

• Listeria monocytogenes,, gebelik,rombonsefalit

A case of pregnant listeria rombencephalitis returns from the edge of death

Abstract

Listeria monocytogenes is a fecal-orally transmitted zoonotic agent, and can cause central nervous system infections such as meningitis, encephalitis, meningoencephalitis, and rhomboncephalitis in pregnant women. Pregnancy is an important predisposing condition for Listeria monocytogenes infections and infection may be severe in pregnant women. In this article, we presented a 28-years-old 8-weeks pregnant woman who was admitted to gynecology and obstetrics clinic with the diagnosed of hyperemesis gravidarum with the complaints of fever, headache, dizziness, nausea and vomiting for 3 days and diagnosed as Listeria monocytogenes. The diagnosis of the patient was made by isolating the bacteria from blood culture together with clinical fndings and detection of rhombencephalitis in magnetic resonance imaging. Antimicrobial treatment was applied to the patient, her pregnancy was terminated with medical abortion. After 6 months therapy, the clinical findings and lesions detected in magnetic resonance imaging were completely recovered.

Keywords

• Listeria monocytogenes,pregnancy,rhombencephalitis

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