目的：探讨成人非围产期中枢神经系统（central nervous system，CNS）单核细胞增生李斯特菌（Listeria monocytogenes，LM）感染的临床特征、诊断及治疗方法，并分析其预后。方法：报道我院6例成人非围产 期CNS-LM感染的病例并结合文献进行回顾性分析。结果：6例患者中，男性3例，女性3例；年龄43～70岁， 发病中位年龄56.5岁。所有患者均有高热（＞39℃），其中5例出现颈强直，4例同时存在发热、意识障碍与 颈强直三联征。5例伴有局灶性神经功能缺损，3例发生痫性发作。5例患者行脑脊液宏基因组二代测序 （mNGS），均检测到LM特异性序列。血培养及脑脊液培养阳性例数均为3例。颅脑影像学检查发现脑膜 强化2例、菱脑炎1例、脑积水2例，1例合并腰骶部脊膜与神经根强化。自症状出现至确诊的中位时间为 12.5 d（范围：4～63 d）。确诊后，3例患者接受氨苄西林（或青霉素）联合庆大霉素的一线方案治疗。最终1例 治愈，3例临床好转但遗留神经功能后遗症，2例因病情危重放弃治疗后死亡。搜索既往报道的CNS-LM患 者317例，最常见的表现是脑膜炎和脑膜脑炎，在所有病例中，有7%的患者表现为脑干脑炎，不到1%合并脊 髓炎和神经根炎。结论：成人CNS-LM感染临床表现异质性强，对于伴有脑干症状或腰骶神经根症状者，需 警惕LM感染可能。脑脊液mNGS可显著提高病原检出效率，对早期诊断具有重要价值。临床初始经验性 抗感染治疗需覆盖LM，早期、足量、联合应用敏感抗菌药物并完成充足疗程，有助于改善患者预后。

To investigate the clinical features, diagnosis, treatment, and prognosis of central nervous system (CNS) infections caused by Listeria monocytogenes(LM) in non-perinatal adults. Methods: A retrospective analysis was conducted on 6 cases of non-perinatal CNS-LM infection in adults at our hospital, combined with a review of the literature. Results: Among the 6 patients, 3 were male and 3 female, with a median age of 56.5 years (range: 43-70 years). All patients presented with high fever (>39℃). Neck stiffness was observed in 5 cases, and 4 of them exhibited the classic triad of fever, impaired consciousness, and neck stiffness. Five patients had focal neurological deficits, and seizures occurred in 3. Cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) was performed in 5 patients, and LM-specific sequences were detected in all. Blood culture and CSF culture were positive in 3 cases each. Neuroimaging revealed meningeal enhancement in 2 cases, rhombencephalitis in 1, hydrocephalus in 2, and concomitant lumbosacral meningeal and nerve root enhancement in 1. The median time from symptom onset to diagnosis was 12.5 days (range: 4-63 days). After diagnosis, 3 patients received first-line therapy with ampicillin (or penicillin) combined with gentamicin. Ultimately, 1 patient was cured, 3 showed clinical improvement but had residual neurological sequelae, and 2 died after withdrawal of treatment due to critical illness. A search of 317 previously reported cases of CNS-LM infection revealed that the most common manifestations were meningitis and meningoencephalitis. Among all cases, 7% presented as brainstem encephalitis and less than 1% of cases involve concurrent myelitis and radiculitis. Conclusion: The clinical presentation of CNS-LM infection in adults is highly heterogeneous. For patients presenting with brainstem symptoms or lumbosacral nerve root symptoms, the possibility of LM infection should be considered. CSF mNGS can significantly improve pathogen detection and is valuable for early diagnosis. Empirical antimicrobial therapy should cover LM. Early initiation of adequate, combination therapy with sensitive antibiotics for a sufficient duration may help improve patient prognosis.