156.2 📚 國考版

156.2.0.1 必背 — 細菌

• Gram + rod, intracellular, cold-tolerant, tumbling motility
• LLO + ActA + Internalin

156.2.0.2 必背 — 三族群

1. 孕婦 (flu-like + 流產/早產 + 新生兒感染)
2. 新生兒 (early/late onset)
3. 老人/免疫低下 (meningoencephalitis, rhombencephalitis)

156.2.0.3 必背 — Empirical Meningitis Cover

• Bacterial meningitis empirical 必須 cover Listeria 若 50+ 或 immunocompromise:
  • Vanco + Ceftriaxone + AMPICILLIN + Dexamethasone
  • (年輕成人 ≤ 50 healthy: vanco + ceftriaxone ± dex 即可)

156.2.0.4 必背 — Treatment

• Amp ± gent
• PCN 過敏 → TMP-SMX
• Ceph 不管用

156.2.0.5 必背 — 食源 outbreak

• 冷藏熟食、軟乳酪、生奶、smoked fish、precut melon

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