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Xia X, Zhang L, Zheng H, Peng X, Jiang L, Hu Y. Clinical characteristics and prognosis of pediatric Listeria monocytogenes meningitis based on 10-year data from a large children's hospital in China. Microbiol Spectr 2024; 12:e0324423. [PMID: 38275295 PMCID: PMC10913449 DOI: 10.1128/spectrum.03244-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 01/27/2024] Open
Abstract
This study aims to summarize the clinical characteristics and prognosis of Listeria monocytogenes (LM) meningitis in children in Chongqing, China. A retrospective analysis of the clinical data and follow-up results of 20 LM meningitis patients admitted to the Children's Hospital of Chongqing Medical University (CHCMU) from January 2012 to December 2022 was performed. The LM meningitis incidence rate was between 0 and 14.3 per 100,000 persons. The median age at onset was 8.98 months. There were five neonate cases, which all had perinatal abnormalities. Seven non-neonatal cases (7/15, 46.7%) had a documented history of contaminated food intake. One case had primary immunodeficiency. The most common symptoms were fever (20/20), altered consciousness (19/20), and vomiting (15/20). Seven cases had seizures, eight cases had cranial nerve involvement, eight cases had positive Babinski sign, and 10 cases had positive meningeal signs. The most common complications were hyponatremia (6/20), hypokalemia (6/20), respiratory failure (5/20), subdural effusion (3/20), and hydrocephalus (2/20). Treatment primarily involved monotherapy or combination therapy with meropenem (15/20) and ampicillin (10/20). Fifteen cases were treated with monotherapy or combination therapy using vancomycin. Twelve cases were successfully followed up from 10 months to 9 years and 6 months, and all had favorable long-term outcomes. LM meningitis incidence in children is low and with nonspecific clinical manifestations. Strengthening food hygiene and safety education, and avoiding infections during pregnancy are important to prevent LM infection in neonates and high-risk individuals. Meropenem and ampicillin are the preferred treatments. Early diagnosis and treatment can improve prognosis.IMPORTANCEThe incidence of LM meningitis is extremely low, and there is currently no standardized treatment. We conducted a retrospective analysis of ten years of data from CHCMU regarding diagnosed LM meningitis cases, aiming to provide clinical evidence for the diagnosis and treatment.
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Affiliation(s)
- Xueqian Xia
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Lingyu Zhang
- Department of Neonatology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hao Zheng
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoling Peng
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, BNU-HKBU United International College, Zhuha, China
| | - Li Jiang
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yue Hu
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Jiang J, Lv M, Yang K, Zhao G, Fu Y. A case report of diagnosis and dynamic monitoring of Listeria monocytogenes meningitis with NGS. Open Life Sci 2023; 18:20220738. [PMID: 37954099 PMCID: PMC10638841 DOI: 10.1515/biol-2022-0738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 11/14/2023] Open
Abstract
Listeria monocytogenes (LM) infections of the central nervous system are deadly and have vague symptoms. Traditional cerebro spinal fluid culture has a low positive rate, and because antibiotic use is common following therapy, it is more challenging to assess the response from pathogen content. In this case, a 66-year-old man who had a fever, a headache, and vomit was admitted to the hospital. He had diabetes, decline in thyroid function, and a history of pituitary tumor removal surgery. His initial treatment with ribavirin, ceftriaxone antibiotic, and moxifloxacin did not go well. Using two etiological tests (culture and metagenomic next-generation sequencing [mNGS]), his cerebrospinal fluid tested positively for LM. Ampicillin-sulbactam and meropenem were used as treatments once LM meningitis was identified. After treatment, his cerebrospinal fluid was assessed once more. Culture: negative; targeted next-generation sequencing (tNGS): positive and shows changes in the copy number of the LM. After 44 days of treatment, the patient finally stopped taking antibiotics, and the prognosis was good. Our study showed that mNGS and tNGS, as novel approaches for pathogen detection, are capable of identifying pathogens quickly, sensitively, and accurately, especially when there are few infections present (such as after antibiotic treatment). The two methods can be a powerful assistance for helping clinicians to choose the best course of action.
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Affiliation(s)
- Jiamei Jiang
- Department of Emergency Medicine, Shanghai Jiaotong University Affiliated Sixth People’ Hospital, No. 600 Yishan Road, Xuhui District, Shanghai200233, China
| | - Meng Lv
- Genoxor Medical Science and Technology Inc., Shanghai201100, China
| | - Kaichao Yang
- Department of Emergency Medicine, Shanghai Jiaotong University Affiliated Sixth People’ Hospital, No. 600 Yishan Road, Xuhui District, Shanghai200233, China
| | - Gang Zhao
- Department of Emergency Medicine, Shanghai Jiaotong University Affiliated Sixth People’ Hospital, No. 600 Yishan Road, Xuhui District, Shanghai200233, China
| | - Yimu Fu
- Department of Emergency Medicine, Shanghai Jiaotong University Affiliated Sixth People’ Hospital, No. 600 Yishan Road, Xuhui District, Shanghai200233, China
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Nachmias B, Orenbuch-Harroch E, Makranz C, Nechusthan H, Eliahou R, Ben-Yehuda D, Lossos A. Early hydrocephalus in Listeria meningitis: Case report and review of the literature. IDCases 2018; 14:e00455. [PMID: 30237977 PMCID: PMC6141257 DOI: 10.1016/j.idcr.2018.e00455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/03/2018] [Accepted: 09/03/2018] [Indexed: 01/28/2023] Open
Abstract
Listeria monocytogenes is a gram-positive bacterium with a predilection to infect the central nervous system, often affecting immunocompromised or elderly patients. The most common manifestations are meningitis and rhomboencephalitis. We report two cases of Listeria meningitis complicated by acute hydrocephalus several days after presentation and we further review the literature of similar cases. We conclude that acute hydrocephalus is a significant, not often recognized, complication of Listeria meningitis, usually occurring several days from onset when coverage did not include anti-Listeria antimicrobials. In high risk patients, meningitis combined with acute hydrocephalus is suggestive of LM infection.
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Affiliation(s)
- B Nachmias
- Hadassah-Hebrew University Medical Center, Department of Hematology, Jerusalem, Israel
| | - E Orenbuch-Harroch
- Hadassah-Hebrew University Medical Center, Department of Infectious disease, Jerusalem, Israel
| | - C Makranz
- Leslie and Michael Gaffin Center for Neuro-Oncology, Departments of Oncology and Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - H Nechusthan
- Hadassah-Hebrew University Medical Center, Department of Oncology, Jerusalem Israel
| | - R Eliahou
- Hadassah-Hebrew University Medical Center, Department of Neuro-imaging, Jerusalem, Israel
| | - D Ben-Yehuda
- Hadassah-Hebrew University Medical Center, Department of Hematology, Jerusalem, Israel
| | - A Lossos
- Leslie and Michael Gaffin Center for Neuro-Oncology, Departments of Oncology and Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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