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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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2
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Campos P, Resende MM, Fradique AR, Neves N, Lemos SG, Rodrigues F. Listeria monocytogenes Meningitis in a Healthy 3-Year-Old Child. Clin Pediatr (Phila) 2024; 63:167-170. [PMID: 37804140 DOI: 10.1177/00099228231204482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Affiliation(s)
- Patrícia Campos
- Department of Paediatrics, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | | | - Ana Rita Fradique
- Department of Paediatrics, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Nelson Neves
- Department of Paediatrics, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Sónia Gaspar Lemos
- Department of Paediatrics, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Fernanda Rodrigues
- Department of Paediatrics, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Ryabinkina YV, Shapovalenko TV, Polishchuk RV, Luneva IE, Koneva EE, Sidyakina IV, Yatsko KA. [Listeria meningoencephalitis resulting in complete bilateral ophtalmoplegia and locked-in syndrome]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:140-147. [PMID: 38465823 DOI: 10.17116/jnevro2024124021140] [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] [Indexed: 03/12/2024]
Abstract
This is a description of the case of quite severe neurolisteriosis in an adult man resulting in the rare combination of neurological symptoms such as complete bilateral ophtalmoplegia and locked-in syndrome. The case illustrates clinical features that are special for this disorder and also highlights management of such patients.
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Affiliation(s)
| | | | | | - I E Luneva
- Research Center of Neurology, Moscow, Russia
| | - E E Koneva
- Clinical Hospital MEDSI in Otradnoye, Moscow, Russia
| | - I V Sidyakina
- Clinical Hospital MEDSI in Otradnoye, Moscow, Russia
| | - K A Yatsko
- Research Center of Neurology, Moscow, Russia
- Lomonosov Moscow State University, Moscow, Russia
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Maraolo AE, Mazzitelli M. Predisposing factor, impactful adjunctive treatment or unfavorable prognostic marker: a meta-analysis on the elusive role of dexamethasone for Listeria monocytogenes meningitis. J Infect Dev Ctries 2023; 17:1748-1752. [PMID: 38252726 DOI: 10.3855/jidc.18804] [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: 06/25/2023] [Accepted: 10/17/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION There are no randomized controlled trials to inform the choice of using adjunctive dexamethasone (AD) against Listeria monocytogenes meningitis (LMM) and data from observational studies are pretty conflicting. METHODOLOGY We performed a rapid review of the literature with quantitative analysis. A pairwise random-effects meta-analysis was implemented, pooling unadjusted and adjusted data. The main outcome was mortality. RESULTS Across all included studies (five) informing the main analysis on raw mortality data, 199 patients received AD, as opposed to 382 who did not receive AD. All-cause mortality was slightly lower in patients undergoing AD, but not in a statistically significant manner: odds ratio 0.96, 95% confidence interval 0.42-2.19. The prediction interval was very wide (0.06-15.99), suggesting that in future studies the effect of AD might be either beneficial or harmful. CONCLUSIONS The role of AD for LMM still needs to be established being the current evidence inconclusive and heterogeneous.
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Affiliation(s)
| | - Maria Mazzitelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
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Choudhury P, Mohanty S, Reddy Y, Reddy N. A Rare Case of Listeria Meningitis With Spinal Involvement. Pediatr Infect Dis J 2023; 42:e498-e499. [PMID: 37851965 DOI: 10.1097/inf.0000000000004100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Affiliation(s)
- Prerna Choudhury
- Paediatric Neurology, Rainbow Children's Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Shashwat Mohanty
- Paediatric Intensive Care Unit, Rainbow Children's Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Yeshwanth Reddy
- Paediatric Intensive Care Unit, Rainbow Children's Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Nihaal Reddy
- Paediatric Neuroradiology, Rainbow Children's Hospital, Hyderabad, Telengana, India
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Kocsis T, Molnár B, Ribiczey P, Kovács M. [A case of community-acquired Listeria monocytogenes meningitis]. Orv Hetil 2023; 164:1437-1441. [PMID: 37695717 DOI: 10.1556/650.2023.32809] [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: 03/23/2023] [Accepted: 04/30/2023] [Indexed: 09/13/2023]
Abstract
Meningitis caused by Listeria monocytogenes is a rare disease in immunocompetent individuals, however, in the presence of certain risk factors with clinical signs indicating infection of the central nervous system it should not be ignored. In this case report, we present the medical history of a 72-year-old man, suffering from hypertension and liver cirrhosis, who was diagnosed with meningitis caused by L. monocytogenes. The patient was admitted to our Department with the symptoms of weakness, dizziness, high fever and urinary incontinence. Laboratory tests showed elevated inflammatory and liver enzyme values as well as low white blood cell and platelet counts were confirmed. Imaging tests did not prove any abnormalities. Due to septic parameters, after microbiological samples were collected, empiric ceftriaxon and metronidazol treatment was started. Despite our therapeutic efforts, the condition of the patient had not improved significantly. The patient still suffered from high fever; increasing agitation and tremor, coordination disorder appeared, raising the possibility of a bacterial infection of the central nervous system. Examination of the cerebrospinal fluid confirmed the diagnosis of bacterial meningitis. In the meantime, findings of microbiological cultures verified the infection of L. monocytogenes, however, cerebrospinal fluid culture did not detect any pathogen. Following that, the therapy continued with targeted ampicillin which resulted in rapid improvement of the patient's condition; fevers and neurological symptoms have ceased to exist. We considered the case worthy of presentation because of the pitfalls of the diagnosis, the emerging differential diagnostic difficulties and the favorable outcome due to the effectiveness of targeted antibiotic treatment. Orv Hetil. 2023; 164(36): 1437-1441.
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Affiliation(s)
- Tícia Kocsis
- 1 Zala Vármegyei Szent Rafael Kórház, I. Belgyógyászati és Infektológiai Osztály Zalaegerszeg, Zrínyi M. u. 1., 8900 Magyarország
| | - Bálint Molnár
- 2 Zala Vármegyei Szent Rafael Kórház, Neurológiai Osztály Zalaegerszeg Magyarország
| | - Pál Ribiczey
- 1 Zala Vármegyei Szent Rafael Kórház, I. Belgyógyászati és Infektológiai Osztály Zalaegerszeg, Zrínyi M. u. 1., 8900 Magyarország
| | - Mónika Kovács
- 1 Zala Vármegyei Szent Rafael Kórház, I. Belgyógyászati és Infektológiai Osztály Zalaegerszeg, Zrínyi M. u. 1., 8900 Magyarország
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Ueno A, Ikawa M, Maeda K, Tai K, Ito T, Shirafuji N, Yamamura O, Nakamoto Y, Hamano T. Persistent Severe Cerebral Edema with Neutrophil Infiltration Following Listeria Meningitis. Intern Med 2022; 61:3431-3434. [PMID: 35466161 PMCID: PMC9751728 DOI: 10.2169/internalmedicine.8291-21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A 51-year-old man was admitted to the hospital with a diagnosis of Listeria monocytogenes meningitis. Diffuse cerebral edema appeared after improvement of meningitis with appropriate treatment and worsened for two months. Due to brain herniation, brain tissue leaked through the incision made during the drain insertion in a hydrocephalus surgery. We found pathological evidence of significant neutrophil infiltration with a few lymphocytes without bacterial detection in the degraded brain tissue. The present case indicates that fatal cerebral edema with significant neutrophil infiltration may develop even after appropriate treatment for L. monocytogenes meningitis.
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Affiliation(s)
- Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Neurology, Fukui-ken Saiseikai Hospital, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Japan
| | - Kenichiro Maeda
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Neurology, Fukui-ken Saiseikai Hospital, Japan
| | - Katsuhide Tai
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tomomi Ito
- Division of Diagnostic Pathology, University of Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Japan
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Zhang X, Wang R, Luo J, Xia D, Zhou C. Detection of meningoencephalitis caused by Listeria monocytogenes with ischemic stroke-like onset using metagenomics next-generation sequencing: A case report. Medicine (Baltimore) 2021; 100:e26802. [PMID: 34397834 PMCID: PMC8341303 DOI: 10.1097/md.0000000000026802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/12/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Listeria monocytogenes (L. monocytogenes) is a compatible intracellular bacterial pathogen that can invade different mammalian cells and reach the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), conventional tests are often reported as negative due to antibiotic therapy or low bacterial content in cerebrospinal fluid. To date, prompt diagnosis and accurate treatment remain a challenge for patients with Listeria infections. PATIENT CONCERNS Here, we report a case of a 64-year-old male diagnosed with LMM by using metagenomics next-generation sequencing (mNGS). DIAGNOSIS LMM was confirmed by mNGS analysis of cerebrospinal fluid. INTERVENTIONS The patient was treated with piperacillin and sensitive antibiotics. OUTCOMES The patient could walk independently about 1 month after admission and was discharged from the hospital. LESSONS This case highlights the value of mNGS in the diagnosis of LMM and emphasizes the inadequate sensitivity of conventional diagnostic methods for Listeria infection.
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Affiliation(s)
- Xiaobo Zhang
- Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China
| | - Ruying Wang
- Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China
| | - Jie Luo
- Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China
| | - Danni Xia
- Department of Laboratory, The First People's Hospital of Changde City, Changde, Hunan, China
| | - Chaojun Zhou
- Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China
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9
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Sugiura K, Ihara T. Intracranial bruits in meningitis. Intern Emerg Med 2021; 16:777-778. [PMID: 33392970 DOI: 10.1007/s11739-020-02579-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/17/2020] [Indexed: 11/27/2022]
Abstract
Intracranial bruits (ICB) are faint, high-pitched, and mostly heard on the orbit in the systolic phase of the cardiovascular cycle. This report discusses a case of Listeria monocytogenes meningitis in a 17-month-old male patient in whom ICB were auscultated. ICB is thought to be caused by compression of blood vessels due to increased intracranial pressure and may serve as an additional sign supporting the diagnosis of meningitis. The present report contains video data on the ICB.
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Affiliation(s)
- Kenta Sugiura
- Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, 2-8-29, Musashidai, Fuchu, Tokyo, 183-8561, Japan.
| | - Takateru Ihara
- Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, 2-8-29, Musashidai, Fuchu, Tokyo, 183-8561, Japan
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Hassin O, Danino D, Schreiber R, Leibovitz E, Amit N. Listeria Meningitis in an Immunocompetent Adolescent. Isr Med Assoc J 2020; 22:195-196. [PMID: 32147988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Ori Hassin
- Department of Pediatrics A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dana Danino
- Department of Pediatrics A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Division of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ruth Schreiber
- Department of Pediatrics A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Eugene Leibovitz
- Division of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Nahum Amit
- Department of Pediatrics A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Glimåker M, Naucler P, Sjölin J. Etiology, clinical presentation, outcome and the effect of initial management in immunocompromised patients with community acquired bacterial meningitis. J Infect 2020; 80:291-297. [PMID: 31911260 DOI: 10.1016/j.jinf.2019.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/05/2019] [Revised: 12/27/2019] [Accepted: 12/28/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The aim was to analyze differences in clinical presentation, etiology, management, and outcome between immunocompromised and immunocompetent patients with acute bacterial meningitis (ABM). METHODS Data were extracted from 1056 adult ABM patients prospectively registered in the national Swedish quality register for ABM during 2008-2017. Primary endpoint was 30-day mortality and secondary endpoints 90-day mortality and unfavorable outcome. RESULTS An immunocompromised state was observed in 352 (33%) of the 1056 patients. Streptococcus pneumoniae dominated in both immunocompromised and immunocompetent patients (53% in both groups), whereas L monocytogenes occurred in 11% and 2%, respectively. The unadjusted odds ratio (OR) for 30-day mortality in immunocompromised compared to immunocompetent patients was 1.68 (95% confidence interval (CI): 1.07-2.63). Adjusted for age, sex, and mental status on admission the OR was 1.34 (CI: 0.82-2.21). Adjusted also for time to antibiotic treatment and corticosteroids the OR was 1.10 (CI: 0.59-2.05), and in patients without Listeria meningitis 0.98 (CI: 0.50-1.90). Although, the ORs were higher for 90-day mortality and unfavorable outcome the effects of adjustments were similar. CONCLUSION Mortality in immunocompromised patients with ABM is only moderately increased unless caused by Listeria. This difference is further reduced in patients given early antibiotic treatment and adjunctive corticosteroids. FUNDING This work was supported by Stockholm County Council.
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Affiliation(s)
- Martin Glimåker
- Unit of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet and Department of Infectious Diseases, Karolinska University Hospital, 171 76 Stockholm, Sweden.
| | - Pontus Naucler
- Unit of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet and Department of Infectious Diseases, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Jan Sjölin
- Section of Infectious Diseases, Department Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden
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12
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Paciorek M, Bienkowski C, Bednarska A, Kowalczyk M, Krogulec D, Makowiecki M, Bursa D, Pula J, Raczynska J, Porowski D, Skrzat-Klapaczynska A, Zielenkiewicz M, Radkowski M, Laskus T, Horban A. The clinical course and outcome of Listeria monocytogenes meningitis: A retrospective single center study. Neuro Endocrinol Lett 2019; 40:79-84. [PMID: 31785214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of the study was to determine clinical manifestations and outcome of Listeria monocytogenes meningitis (LM) and to compare with other forms of bacterial meningitis (BM). MATERIAL AND METHODS We analyzed records of all adult patients with BM who were hospitalized between January 2010 and December 2017 in the largest neuroinfection center in Poland. RESULTS Out of 343 analyzed patients with BM 24 were diagnosed to have LM. Patients with LM were older compared to patients with other forms of BM (62 years vs. 57 years, p=0.039), were more likely to have cancer (16.7% vs. 4.7%, p=0.045), receive immunosuppressive treatment (45.8% vs. 10.7%, p<0.001), or be immunocompromised in any way (62.5% vs. 35.5%, p=0.016). Blood tests showed lower WBC (10.7 × 103 cells/µl vs. 15.5 × 103 cells/µl, p=0.004), C-reactive protein (150 mg/L vs. 221 mg/L, p=0,019) and procalcitonin (1.27 ng/mL vs. 3.78 ng/mL, p=0.003) in LM group. Analysis of cerebrospinal fluid showed lower cell count (531.5 cells/µL vs. 1100 cells/µL, p<0.001) and lower chloride (113 mmol/L vs. 117 mmol/L, p=0.036) in patients with LM. In the multiple logistic regression analysis, immunosuppressive therapy was the only variable independently associated with LM (OR:8.72, CI 95%:1.41-64.34, p=0.024). CONCLUSIONS LM is associated with older age, cancer and immunosuppressive therapy. However, in multivariate analysis only immunosuppressive therapy turned out to be an independent risk factor for LM.
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Affiliation(s)
- Marcin Paciorek
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Carlo Bienkowski
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Bednarska
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Monika Kowalczyk
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Krogulec
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Michal Makowiecki
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Dominik Bursa
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Pula
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Raczynska
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Dawid Porowski
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Marek Radkowski
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Laskus
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Horban
- Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
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13
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McCarthy KN, Leahy TR, Murray DM. Listeria Meningitis in an Immunocompetent Child: Case Report and Literature Review. Ir Med J 2019; 112:939. [PMID: 31411392] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We present a case of a 23 month-old boy presenting with fever, irritability and diarrhea who subsequently developed symptoms of photophobia and lethargy. Cerebrospinal fluid culture grew Listeria monocytogenes. Immunology investigations were normal. This patient had a complete and uncomplicated recovery. Listeria meningitis is a rare presentation in immunocompetent children, but should be considered in the setting of diarrhea, failure to respond to cephalosporin therapy, or suspected immunodeficiency.
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Affiliation(s)
- K N McCarthy
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland
| | - T R Leahy
- Department of Paediatric Immunology and ID, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland
| | - D M Murray
- Infant Research Centre, Cork University Hospital, Cork, Ireland
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14
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Jain S, Otta S, Swain B, Sahoo S. Listerial meningitis: A diagnostic dilemma. J Postgrad Med 2019; 65:64-65. [PMID: 30693878 PMCID: PMC6380126 DOI: 10.4103/jpgm.jpgm_431_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- S Jain
- Department of Microbiology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India E-mail:
| | - S Otta
- Department of Microbiology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India E-mail:
| | - B Swain
- Department of Microbiology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India E-mail:
| | - S Sahoo
- Department of Microbiology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India E-mail:
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Xu J, Gao F, Yuan Z, Jiang L, Xia Z, Zhao Z. Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) associated with bacteria meningitis caused by listeria monocytogenes: A case report. Medicine (Baltimore) 2018; 97:e11561. [PMID: 30045281 PMCID: PMC6078722 DOI: 10.1097/md.0000000000011561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Mild encephalitis/encephalopathy with a reversible splenial lesion is a clinico-radiological syndrome mainly triggered by viral infection. Bacteria, like listeria monocytogenes, are relatively rare pathogens. PATIENT CONCERNS A two and a half years old girl with a 3-day history of fever and vomiting, complicated by a sudden seizure. She was in a coma after seizure. DIAGNOSES Listeria monocytogenes was detected in cerebrospinal fluid cultures. Serum IL-6 remarkably elevated, and hyponatremia appeared on day 2 of hospitalization. Magnetic resonance imaging of the brain performed on day 3 of hospitalization showed right subdural effusion and a lesion in the central portion of the splenium of the corpus callosum. INTERVENTIONS We administered antimicrobial therapy, intravenous mannitol and hypertonic fluid therapy. OUTCOMES Her neurological symptoms improved gradually. The lesion in the splenium of the corpus callosum completely disappeared on magnetic resonance imaging on day 10 of hospitalization. LESSONS We diagnosed this case as mild encephalitis/encephalopathy with a reversible splenial lesion caused by listeria monocytogenes. The patient recovered completely clinically and on imaging, without any specific immunomodulatory treatment. It also indicated IL-6 may play a role in the forms of hyponatremia in mild encephalitis/encephalopathy with a reversible splenial lesion.
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Prykuda N, Zadorożnyi A. The case of septical form of listeriosis with numerous abscesses of liver. Przegl Epidemiol 2018; 72:53-57. [PMID: 29667380] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The article describes the case of a septic form of a listeriosis with multiple abscesses of the liver. Given clinical example illustrates the severe course of listeriosis with the development of septicemia and lesions of internal organs. Despite the adequate etiotropic and pathogenetic treatment for listeriosis meningoencephalitis, there was a lethal outcome of the disease. The polymorphism of clinical manifestations and the range of course variants often make it difficult to diagnose listeriosis, which in turn requires a more thorough examination of patients as well as carrying out all relevant bacteriological and serological tests.
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Affiliation(s)
- Nadiya Prykuda
- Danylo Halytsky National Medical University Lviv, Department of Infectious Diseases
| | - Andrij Zadorożnyi
- Danylo Halytsky National Medical University Lviv, Department of Infectious Diseases
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Pagliano P, Arslan F, Ascione T. Epidemiology and treatment of the commonest form of listeriosis: meningitis and bacteraemia. Infez Med 2017; 25:210-216. [PMID: 28956537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Listeria monocytogenes is a Gram-positive bacillus and facultative intracellular bacterium whose transmission occurs mainly through the consumption of contaminated food. Listeriosis has an incidence estimated at around three-six cases per million per year and the most common forms of the infection are neurolisteriosis, bacteraemia, and maternal-neonatal infection. Those affected by listeriosis are at the extremes age of the life or report specific risk factors, such as malignancies, causing a defect of cellular immunity. Patients with L. monocytogenes meningitis present with signs and symptoms similar to those reported in the general population with community-acquired bacterial meningitis, but can experience a longer prodromal phase. Instead, patients with bacteraemia present generally with a febrile illness without focal symptoms, or with influenza-like symptoms and diarrhoea. These aspecific findings make the diagnosis difficult in the population of patients at the highest risk such as cirrhotics or those receiving chemotherapy. Mortality rate is estimated around 20% with a significant increase among those reporting a delay in diagnosis and treatment and in those with severe comorbidity. A number of antibiotics have been demonstrated to be active against L. monocytogenes, but penicillin, amoxicillin, and ampicillin are those used with the highest frequency and suggested by current guidelines and expert opinions. These antibiotics bind to PBP-3 with high affinity and are stored in the cytosol when taken up by cells. Although amoxicillin appears to have a better activity than ampicillin on the basis of in vitro studies, ampicillin is currently the drug of choice for the treatment of listeriosis. Cotrimoxazole could be administered as an alternative treatment; its use is associated with a favourable outcome probably due to the favourable penetration with brain. Quinolones have an excellent tissue and cell penetration and are rapidly bactericidal, but their clinical activity is not as high as we can predict on the basis of experimental model. Linezolid offers a number of advantages in the empiric treatment of meningitis due to its favourable penetration of CSF and the absence of bacteriolytic effect on S. pneumoniae as confirmed by a number of case-series highlighting its use as rescue therapy of pneumococcal meningitis, but data are currently limited particularly if we consider neurolisteriosis. Combination therapies have been proposed to enhance the activity of penicillins against Listeria in an attempt to achieve complete killing and decrease mortality. Steroids use is ineffective.
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Affiliation(s)
- Pasquale Pagliano
- AORN dei Colli, D. Cotugno Hospital, Department of Infectious Diseases, Naples, Italy
| | - Ferhat Arslan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Hospital, Istanbul, Turkey
| | - Tiziana Ascione
- AORN dei Colli, D. Cotugno Hospital, Department of Infectious Diseases, Naples, Italy
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Infante-Urrios A, Buñuel-Adan F, Gázquez-Gómez G, Ortiz de la Tabla-Ducasse V. Listeria monocytogenes meningitis: PCR multiplex diagnosis. Enferm Infecc Microbiol Clin 2017; 36:61-62. [PMID: 28473173 DOI: 10.1016/j.eimc.2017.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 03/18/2017] [Accepted: 03/20/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Ana Infante-Urrios
- Servicio de Microbiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, España.
| | - Fernando Buñuel-Adan
- Servicio de Microbiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, España
| | - Gregoria Gázquez-Gómez
- Servicio de Microbiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, España
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19
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Żak-Gołąb A, Dąbrowski K, Hrycek A. [Listeriosis of central nervous system in patients with ulcerative colitis - case study]. Wiad Lek 2017; 70:685-688. [PMID: 28713103] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the recently an increase morbidity inflammatory bowel disease, including ulcerative colitis was observed. The use of purine analogs and their metabolites are associated with a higher incidence of infections in this group of patients. Listeriosis is an infectious disease caused by a relatively anaerobic gram-positive bacteria - Listeria monocytogenes. Common symptoms include fever, nausea, vomiting and diarrhea, but these pathogens can also cause myocarditis, central nervous system infections, including brain abscesses and sepsis. Since the incidence of Listeria monocytogenes is higher in patients with inflammatory bowel disease than in the general population, it is important to pay special attention to this group of patients (in prophylaxis as well as treatment) as these infections are serious and often fatal among them.
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Affiliation(s)
- Agnieszka Żak-Gołąb
- Klinika Chorób Wewnętrznych, Autoimmunologicznych I Metabolicznych, Śląski Uniwersytet Medyczny, Katowice, Polska
| | - Krzysztof Dąbrowski
- Oddział Onkologii Klinicznej, Uck Im. Prof. K. Gibińskiego, Śląski Uniwersytet Medyczny, Katowice, Polska
| | - Antoni Hrycek
- Klinika Chorób Wewnętrznych, Autoimmunologicznych I Metabolicznych, Śląski Uniwersytet Medyczny, Katowice, Polska
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20
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Pagliano P, Ascione T, Boccia G, De Caro F, Esposito S. Listeria monocytogenes meningitis in the elderly: epidemiological, clinical and therapeutic findings. Infez Med 2016; 24:105-111. [PMID: 27367319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Listeria monocytogenes is a Gram-positive bacillus and facultative intracellular bacterium whose transmission occurs mainly through the consumption of contaminated food, L. monocytogenes invades the host cells using various protein and can escape to the human T-cell immune system by cell-to-cell spreading. If the infection is not controlled at the stage in which the bacterium is in the liver, for instance, due to a severe immunodepression, a secondary bacteraemia can be developed and L. monocytogenes reaches the preferred sites transgressing the blood-brain barrier or the placental barrier. Individuals with T-cell dysfunction, such as pregnant women, the elderly, and those receiving immunosuppressive therapy are at the highest risk of contracting the disease. Average life expectancy throughout developed countries has rapidly increased during the latter half of the 20th century and geriatric infectious diseases have become an increasingly important issue. L. monocytogenes meningitis in young previously healthy adults has been reported only in anecdotal observations. Differently, L. monocytogenes is the third most common cause of bacterial meningitis in the elderly population, after Streptococcus pneumoniae and Neisseria meningitidis. Patients with L. monocytogenes meningitis presented with signs and symptoms that were similar to those of the general population with community-acquired bacterial meningitis, but reported a longer prodromal phase. According to literature data, the prevalence of the classic triad of fever, neck stiffness, and altered mental status is 43%, and almost all patients present with at least 2 of the 4 classic symptoms of headache, fever, neck stiffness, and altered mental status. On the basis of our published data, in patients aged over 50 years, diagnosing L. monocytogenes meningitis was more challenging than pneumococcal meningitis, as demonstrated by the lower percentage of cases receiving a correct diagnosis within 48 hours from the onset of symptoms. No significant difference was observed in respect to the presenting symptoms, but progression to respiratory failure was not as rapid as pneumococcal meningitis.
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Affiliation(s)
- Pasquale Pagliano
- AORN dei Colli, D. Cotugno Hospital, Department of Infectious Diseases, Naples, Italy
| | - Tiziana Ascione
- AORN dei Colli, D. Cotugno Hospital, Department of Infectious Diseases, Naples, Italy
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21
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Kobayashi T, Tadokoro H, Odai T, Hibino T, Waki K. A Delayed Cerebral Vasospasm with Infarction Is Secondary to Listeria monocytogenes Meningitis: MRI and MRA Are Diagnostically Useful. Intern Med 2015; 54:2935-8. [PMID: 26568013 DOI: 10.2169/internalmedicine.54.5010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Among patients with bacterial meningitis, a cerebral vasospasm typically occurs during the acute phase. We experienced a case of delayed cerebral vasospasm with infarction that was secondary to Listeria monocytogenes meningitis. An 82-year-old woman with Listeria monocytogenes meningitis, whose symptoms had been improving after the initiation of antibacterial therapy, fell into a coma on day 15 and developed generalized seizure. Magnetic resonance imaging (MRI) and MR angiography (MRA) indicated a cerebral vasospasm with multiple infarctions. The risk of vascular complications following acute bacterial meningitis requires close follow-up to identify neurological changes and a low threshold for vascular evaluation. In such cases, MRI and MRA have diagnostic utility.
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Anyfantakis D, Volakakis N, Kosmidou K, Polimili G, Kastanakis S. Listeria monocytogenes-associated meningitis and arthritis in an immunocompetent 65-year-old woman: a case report. Infez Med 2014; 22:132-135. [PMID: 24955800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report an unusual case of concurrent meningitis and infectious monoarthritis due to Listeria monocytogenes in a 65-year-old woman presenting to our department with a transient gastrointestinal tract illness. During hospitalization the patient's neurological status deteriorated, presenting signs of meningeal irritation along with signs of inflammation and oedema of the right knee. Blood cultures and cultures of the cerebrospinal fluid and of the sinovial fluid aspirate showed growth of L. monocytogenes gram positive rods. The patient received a three-week course of intravenous meropenem with significant improvement. To the best of our knowledge this is the first case of concurrent listerial meningitis and arthritis in an immunocompetent patient. Despite the rarity of the disease in healthy individuals a high index of suspicion is required for unusual manifestations of listerial infections especially among high risk groups such as the elderly.
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Affiliation(s)
- Dimitrios Anyfantakis
- Primary Health Care Centre of Kissamos; First Department of Internal Medicine, Saint George General Hospital of Chania, Crete, Greece
| | - Nikolaos Volakakis
- Primary Health Care Centre of Kissamos; First Department of Internal Medicine, Saint George General Hospital of Chania, Crete, Greece
| | - Kiriaki Kosmidou
- Primary Health Care Centre of Kissamos; First Department of Internal Medicine, Saint George General Hospital of Chania, Crete, Greece
| | - Georgia Polimili
- Primary Health Care Centre of Kissamos; First Department of Internal Medicine, Saint George General Hospital of Chania, Crete, Greece
| | - Serafim Kastanakis
- Primary Health Care Centre of Kissamos; First Department of Internal Medicine, Saint George General Hospital of Chania, Crete, Greece
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23
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Affiliation(s)
- Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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24
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Kang QH, Guo Y, Hong SQ, Jiang L. [Listeria monocytogenes meningitis in infants: report of two cases]. Zhongguo Dang Dai Er Ke Za Zhi 2013; 15:1150-1152. [PMID: 24342220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Qing-Hua Kang
- Department of Pediatrics, Meitan People's Hospital of Guizhou Province, Meitan, Guizhou 564100, China
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25
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Limmahakhun S, Chayakulkeeree M. Listeria monocytogenes brain abscess: two cases and review of the literature. Southeast Asian J Trop Med Public Health 2013; 44:468-478. [PMID: 24050079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Listeria monocytogenes is a gram-positive bacillus that exhibits predilection to infect the central nervous system in immunocompromised individuals; the most common manifestations are meningitis and rhombencephalitis. Listerial brain abscesses are rare. We report here two brain abscess cases caused by L. monocytogenes in patients receiving immunosuppressive agents. The first patient presented with left hemiparesis mimicking stroke and the second patient presented with neurological symptoms without fever, which was indistinguishable from brain tumor. In both cases, magnetic resonance spectroscopy (MRS) was performed to differentiate infectious processes from other causes. Diagnosis was made with a positive blood culture in both cases. Listerial DNA was detected in the pus aspirated from the abscess in the first case. Both patients were successfully treated with intravenous ampicillin followed by oral amoxicillin. MRS was useful in differentiating infectious processes from non-infectious causes.
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Affiliation(s)
- Samornrod Limmahakhun
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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26
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Teodor A, Teodor D, Miftode E, Prisăcaru D, Leca D, Petrovici C, Dorneanu O, Dorobăt CM. Severe invasive listeriosis--case report. Rev Med Chir Soc Med Nat Iasi 2012; 116:808-811. [PMID: 23272533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Listeriosis is a rare food borne infection which, in the invasive form, presents as bloodstream infection, central nervous system infection, materno-fetal infection, or focal infection. Certain immunosuppressive conditions have been identified as risk factors for severe invasive disease. The invasive forms of listeriosis are associated with a high case fatality rate. We present the case of a 62-year-old male with an unremarkable medical history admitted to the Iasi Infectious Diseases Hospital for fever. headache, ataxia, and diplopia. Physical examination revealed high temperature, confusion, relative bradycardia, and signs of meningeal irritation. Laboratory test showed leukocyt osis with neutrophilia. pathological CSF findings (high WBC count with predominance of neutrophils, low glucose and high protein levels), increased liver enzymes (ALAT, ASAT, AP, gammaGT), and important renal impairment (normal levels at presentation). No abnormalities at chest x-ray, cranial CT and abdominal ultrasound. CSF and blood cultures were positive for Listeria monocytogenes. Under antibiotics (ampicillin and ciprofloxacin), the course was marked by respiratory failure requiring mechanical ventilation, coma, hypotension, tachycardia. and death 12 days after admission. The particularity of this case consists in the association of the two classical forms of invasive listeriosis, meningitis and bacteriemia, with a focal infection. acute hepatitis, and a course marked by multiple organ dysfunction syndromes and exitus in a previously apparently healthy individual.
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Affiliation(s)
- Andra Teodor
- University of Medicine and Pharmacy Grigore T. Popa-Iasi School of Medicine
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27
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Sedney CL, Harshbarger T, Gyure K. An unusual form of listerial CNS infection. W V Med J 2012; 108:12-15. [PMID: 22872959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Listeria monocytogenes is a known cause of meningitis, but cerebral abscess formation is exceedingly rare. We describe a patient who presented with an unsteady gait and a small ring-enhancing lesion in the right parietal lobe. Pathologic evaluation demonstrated an abscess with associated microglial nodules, and culture revealed Listeria. In spite of the rarity of this entity, immunosuppression has been noted to be a predisposing factor. Our patient had diabetes mellitus and chronic obstructive pulmonary disease with recent prednisone administration, both very common ailments in the population of West Virginia.
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Affiliation(s)
- Cara L Sedney
- West Virginia University, Department of Neurosurgery, USA
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Paciorek M, Przyjałkowski W, Lipowski D, Czekalska-Lachowicz E, Horban A. [Listeriosis of the central nervous system: epidemiological and diagnostic aspects--own observations]. Przegl Epidemiol 2011; 65:63-66. [PMID: 21735838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED The aim of the study was to evaluate clinical and laboratory findings and predisposing factors for Listeria monocytogenes (Lm) meningitis. METHODS 17 intensive care unit patients (12 M, 5 F), aged 54.4 +/- 15.3 yrs, were studied. CNS listeriosis was confirmed by culture of cerebrospinal fluid (CSF) or CSF pleocytosis coupled with Lm bacteriemia. RESULTS The frequency of central nervous system (CNS) listeriosis among patients with bacterial meningitis was 5.5%. Meningeal signs were present in all patients. 15 patients had impaired level of consciousness. Possible predisposing factors occurred in 15 patients. The average CSF white blood cell count was 1034 +/- 1064 cells/microl. CONCLUSION Symptoms and signs of patients with CNS listeriosis were not different from those usually found in other bacterial meningitis. A trend toward fewer WBC in CSF was revealed. Most patients with Lm meningitis were immunocompromised.
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Affiliation(s)
- Marcin Paciorek
- Oddział Intensywnej Terapii Wojewódzkiego Szpitala Zakaźnego w Warszawie.
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Abstract
Rogier van Doorn and colleagues from Ho Chi Minh city, Vietnam present a Learning Forum involving three unusual cases of patients with listerial meningitis.
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Affiliation(s)
| | - James I. Campbell
- Oxford University Clinical Research Unit, Wellcome Trust Asia Research Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, Oxford, United Kingdom
| | - Constance Schultsz
- Oxford University Clinical Research Unit, Wellcome Trust Asia Research Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam
- Centre of Poverty-related Communicable Diseases, Academic Medical Centre, Amsterdam, The Netherlands
| | | | - To Song Diep
- Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam
| | - Stephen Baker
- Oxford University Clinical Research Unit, Wellcome Trust Asia Research Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, Oxford, United Kingdom
| | | | - Jeremy J. Farrar
- Oxford University Clinical Research Unit, Wellcome Trust Asia Research Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, Oxford, United Kingdom
| | - H. Rogier van Doorn
- Oxford University Clinical Research Unit, Wellcome Trust Asia Research Programme, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, Oxford, United Kingdom
- * E-mail:
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Klein M. [Community acquired bacterial meningitis]. MMW Fortschr Med 2010; 152:36-39. [PMID: 20672661 DOI: 10.1007/bf03366786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
MESH Headings
- Adult
- Algorithms
- Ampicillin/therapeutic use
- Ceftriaxone/therapeutic use
- Child
- Community-Acquired Infections/diagnosis
- Community-Acquired Infections/drug therapy
- Dexamethasone/therapeutic use
- Diagnosis, Differential
- Drug Therapy, Combination
- Emergencies
- Humans
- Meningitis, Bacterial/diagnosis
- Meningitis, Bacterial/drug therapy
- Meningitis, Listeria/diagnosis
- Meningitis, Listeria/drug therapy
- Meningitis, Meningococcal/diagnosis
- Meningitis, Meningococcal/drug therapy
- Meningitis, Pneumococcal/diagnosis
- Meningitis, Pneumococcal/drug therapy
- Neurologic Examination
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Affiliation(s)
- Matthias Klein
- Neurologische Klinik und Poliklinik, Klinikum Grosshadern, LMU München.
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31
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Dobson R, Shannon C. A 56 year old man with headache, fever, and neurological symptoms. BMJ 2010; 340:b5603. [PMID: 20089575 DOI: 10.1136/bmj.b5603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ruth Dobson
- Leicester General Hospital, Leicester LE5 4PW.
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32
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Brueck M, Bandorski D. [Cerebral T wave inversion and prolonged QTc interval in the surface ECG of a patient with bacterial meningitis]. Med Klin (Munich) 2009; 104:814-816. [PMID: 19856156 DOI: 10.1007/s00063-009-1168-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Martin Brueck
- Medizinische Klinik I, Klinikum Wetzlar, Akademisches Lehrkrankenhaus der Justus-Liebig-Universität Giessen, Giessen, Germany.
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St-Martin G, Fischer TK, Skinhøj P. [Listerial meningitis at the Department of Infectious Diseases, Copenhagen University Hospital 1983-2006]. Ugeskr Laeger 2009; 171:2287-2290. [PMID: 19732509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Listeria monocytogenes rarely causes meningitis, but when it does the course can be severe and case fatality rates high. The article describes clinical and laboratory findings as well as treatment and outcome among patients treated for listerial meningitis at the Department of Infectious diseases, Rigshospitalet from 1983-2006. MATERIAL AND METHODS Patient records were reviewed for all adults with a diagnosis of listerial meningitis. RESULTS A total of 40 patients with a discharge diagnosis of listerial meningitis were identified; records for 36 of these were available. 61% were men and 72% were older than 50 years. 64% had underlying, predisposing illnesses or took immunosuppressant medication. At presentation, patients had fever, neck stiffness, headache and/or change in mental status. The cerebrospinal fluid (CSF) cell count was raised in all patients, but the number and differential count of leukocytes in the CSF varied. L monocytogenes was present in blood and/or CSF from all patients. Treatment records were available for 35 patients, all of whom received ampicillin. Four patients died; they all had underlying diseases and three were older than 50 years. CONCLUSION The present study confirms the findings of other studies showing that listerial meningitis is more common in patients with underlying conditions, immunosuppression or age above 50. The case fatality rate is lower than that found in other reports, which could be due to the selection of patients. Listeriosis is an important differential diagnosis in predisposed individuals.
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Abstract
We report the case of a 81-year-old, immunocompromised Patient, admitted to our hospital with new-onset headaches and word-finding difficulties. The MRI of the brain revealed a temporal mass on the left with marginal contrast-enhancement. During the next days Listeria monocytogenes grew in the bloodcultures so that the diagnosis of a brain-abscess caused by Listeria was established. Due to the localisation, surgical drainage of the abscess was not possible, so that a prolonged antibiotic therapy lasting over 4.5 months was initiated. The MRI after therapy demonstrated no abscess persistence. Listeria mostly cause infections in the immunocompromised, elderly, newborn or pregnant host. Next to bacteraemia without a focus, CNS-invasion with meningitis, meningoencephalitis or less frequent abcess-formation (5-10%) is the most important manifestation.
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Affiliation(s)
- S Tschudin
- Klinik für Infektiologie und Spitalhygiene, Universitätsspital Basel
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Pistella E, Campanile F, Bongiorno D, Stefani S, Di Nucci GD, Serra P, Venditti M. Successful Treatment of Disseminated Cerebritis Complicating Methicillin-resistant Staphylococcus aureus Endocarditis Unresponsive to Vancomycin Therapy with Linezolid. ACTA ACUST UNITED AC 2009; 36:222-5. [PMID: 15119370 DOI: 10.1080/00365540410019345] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A unique case of community acquired methicillin resistant Staphylococcus aureus (MRSA) sepsis, with endocardial and cerebral metastatic seeding, caused by a strain representative of the Italian clone, is described. The patient was a 47-y-old man without apparent risk factors for endocarditis and for MRSA infection who developed coma with multiple cerebritis lesions under vancomycin plus amikacin therapy. He was eventually cured with the addition of linezolid to the initial antimicrobial regimen. This observation seems to confirm previous reports of the efficacy of linezolid for the treatment of central nervous system infections caused by multidrug resistant Gram-positive bacteria. To our knowledge, this is the first report of MRSA disseminated cerebritis, a nearly always fatal disease, cured with this oxazolidinone drug. The increase in community acquired MRSA may have some impact on empirical treatment of serious infections caused by this organism.
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MESH Headings
- Acetamides/administration & dosage
- Bacteremia/complications
- Bacteremia/diagnosis
- Bacteremia/drug therapy
- Community-Acquired Infections/complications
- Community-Acquired Infections/diagnosis
- Community-Acquired Infections/drug therapy
- Dose-Response Relationship, Drug
- Drug Resistance, Multiple, Bacterial
- Endocarditis, Bacterial/complications
- Endocarditis, Bacterial/diagnosis
- Endocarditis, Bacterial/drug therapy
- Follow-Up Studies
- Humans
- Infusions, Intravenous
- Linezolid
- Male
- Meningitis, Listeria/complications
- Meningitis, Listeria/diagnosis
- Meningitis, Listeria/drug therapy
- Methicillin Resistance
- Middle Aged
- Oxazolidinones/administration & dosage
- Risk Assessment
- Severity of Illness Index
- Staphylococcal Infections/complications
- Staphylococcal Infections/diagnosis
- Staphylococcal Infections/drug therapy
- Tomography, X-Ray Computed
- Treatment Outcome
- Vancomycin/administration & dosage
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Affiliation(s)
- E Pistella
- Department of Clinical Medicine, University La Sapienza, viale dell'Università 37, 00161, Roma, Italy
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36
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Protopsaltis J, Kokkoris S, Brestas PS, Chrysos G, Salvanos L, Samara C, Giannoulis G. Neurolisteriosis mimicking herpes simplex encephalitis in an immunocompromized patient. ACTA ACUST UNITED AC 2009; 38:825-8. [PMID: 16938743 DOI: 10.1080/00365540600551323] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Brain MRI was performed in an immunocompromized febrile and lethargic patient, revealing an asymmetric bilateral temporal lobe involvement, strongly suggestive of herpetic encephalitis. Nevertheless, PCR in CSF for Listeria monocytogens was positive. This case implies that Listeria might be considered in patients with clinical and imaging suspicion of herpetic encephalitis.
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Affiliation(s)
- John Protopsaltis
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
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Abstract
Candidemia is the fourth most frequent nosocomial bloodstream infection in the US. The clinical characteristics and outcome of candidemia in adult patients with diabetes mellitus (DM) have not been reported in the literature. The objective of the study was to determine the epidemiology and determinants of mortality in diabetic patients with candidemia. A retrospective cohort study among diabetic patients with candidemia was carried out at 2 medical centers. The primary outcome was death from any cause after the onset of candidemia until discharge from the hospital. A stepwise logistic regression analysis was performed to determine the predictors of mortality. From June 1995 to June 2003, 87 patients with both DM and candidemia were studied. Candida albicans was the most common (48/87, 55%) and Candida glabrata the second most common isolate of candidemia (18/87, 21%). Overall hospital mortality was 39% (34/87). Logistic regression analysis identified 3 independent determinants of death; Apache II score > or =23 (OR 8.3, 95% CI{2.7, 25.4}, p =0.0002), nosocomial candidemia (OR 10.2, 95% CI{1.1, 97.9}, p = 0.04), and mechanical ventilation (OR 3.6, 95% CI{1.1, 11.2}, p = 0.03). The study demonstrates the emergence of non-albicans species of Candida as major causes of candidemia among diabetic patients. The severity of illness reflected by Apache II was the most significant predictor of mortality among diabetic patients with candidemia.
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Affiliation(s)
- Erica Peters
- The Infection, Tropical Medicine and Counselling Service, The Brownlee Centre, Gartnavel General Hospital, Glasgow, UK
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38
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Drnda A, Koluder N, Hadzic A, Bajramovic N, Baljic R, Mulabdic V. Listeria meningoencephalitis in an immunocompetent person. Med Arh 2009; 63:112-113. [PMID: 19537672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Listeria monocytogenes is a small, aerobic or facultative anaerobic, non-sporulating gram positive bacillus that can be isolated from soil, vegetation or animal reservoirs. There are six species of Listeria, and only L. monocytogenes is pathogenic for humans. Human disease occurs mainly in immunocompromised people, neonates and in pregnancy, while the cases in immunocompetent people are rare. CNS manifestations of the disease can be in form of meningitis, encephalitis, and also cerebritis and abscess since L. monocytogenes shows tropism for brain and brain stem as well for the meninges. In this case we presented 55 year old male patient with etiologically confirmed listerial meningoencephalitis, transferred from regional hospital tothe Clinic for Infectious Diseases with diagnosis of acute meningoencephalitis. Disease started 4 days before the admission. Prior to this the patient was completely healthy. In his history he denied any preexisting disease. At admittance he was febrile, with altered consciousness, disoriented, showing ocular deviation, dystaxia, and with completely positive meningeal signs. Neurologist diagnosis was rhombencephalitis. CSF analysis showed mildly opalescent liquor with pleocytosis 546/mm3 and polymorphonuclear cell predominance >70%. CSF culture showed positive isolate of L. monocytogenes. Initial therapy was: Penicillin G and Chloramphenicol, together with all other supportive and symptomatic therapy. After initial therapy and based on antibiogram, ampicillin was administered for4 weeks, followed by imipenemum for 10 days. Control CSF analysis showed pleocytosis and increased protein level and the patient was discharged as recovered with diagnosis of acute meningoencephalitis
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Affiliation(s)
- Alija Drnda
- Clinic for Infectious Diseases, University Clinical Center of Sarajevo, BiH
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39
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Pazderková J, Dlouhý P, Stolbová M, Krejcí J. [Listeriosis - four case reports]. Klin Mikrobiol Infekc Lek 2008; 14:145-148. [PMID: 18821483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The authors described four cases of listeria infection. The patients were hospitalized in the Department of Infectious Diseases of the Masaryk Hospital in Ustí nad Labem during the epidemic outbreak of this infection around the turn of 2006/2007. The disease in three of the four patients was manifested as purulent meningitis and in the remaining one as a sepsis. All of the patients were above the age of 55 years; moreover, two of them were assumed to be immunocompromised. In three of the patients, whose laboratory findings revealed purulent meningitis, direct microscopy of cerebrospinal fluid (CSF), specific latex agglutination test and PCR were negative. Final diagnosis was determined on the basis of the CSF and blood cultures reported 3-4 days after collection. None of the patients suffered from diarrhoea. In the epidemiological anamnesis, only two of them admitted consumption of food that could become source of infection. The patients were successfully treated with either ampicillin and chloramphenicol.
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Affiliation(s)
- J Pazderková
- Infekcní oddelení, Masarykova nemocnice v Ustí nad Labem.
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40
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Elazary R, Abu GM, Adar T, Eichel R, Rivkind AI, Zamir G. Bacterial meningitis and sigmoid diverticulitis caused by Listeria monocytogenes. Isr Med Assoc J 2008; 10:546-547. [PMID: 18751639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Ram Elazary
- Department of General Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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41
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Izbéki F, Nagy F, Szepes Z, Kiss I, Lonovics J, Molnár T. Severe Listeria meningoencephalitis in an infliximab-treated patient with Crohn's disease. Inflamm Bowel Dis 2008; 14:429-31. [PMID: 17973302 DOI: 10.1002/ibd.20286] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Affiliation(s)
- Hisashi Ito
- Department of Neurology, Chigasaki Tokushukai Medical Center, Chigasaki, Japan.
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43
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Cunha BA, Fatehpuria R, Eisenstein LE. Listeria monocytogenes encephalitis mimicking Herpes Simplex virus encephalitis: the differential diagnostic importance of cerebrospinal fluid lactic acid levels. Heart Lung 2007; 36:226-31. [PMID: 17509430 DOI: 10.1016/j.hrtlng.2007.01.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Accepted: 01/08/2007] [Indexed: 12/11/2022]
Abstract
Listeria monocytogenes is a common cause of bacterial meningitis in elderly patients and in those with impaired cellular immunity. The most common central nervous system infection caused by L. monocytogenes is acute bacterial meningitis; meningoencephalitis is uncommon and encephalitis is rare. Early diagnosis of L. monocytogenes meningitis is difficult because only 50% of cerebrospinal fluid (CSF) Gram stains are negative. L. monocytogenes is one of the few central nervous system pathogens associated with red blood cells in the CSF. When L. monocytogenes presents as encephalitis with red blood cells in the CSF, the clinical presentation mimics most closely herpes simplex virus (HSV)-1 encephalitis. Because the therapies for L. monocytogenes and HSV-1 are different, early diagnostic differentiation is clinically important. The CSF lactic acid is the best way to rapidly differentiate between these two entities; the CSF lactic acid level is elevated in L. monocytogenes but is not elevated in HSV-1 encephalitis. The case presented is an elderly man with chronic lymphocytic leukemia who presented with encephalitis. Advanced age and chronic lymphocytic leukemia predispose him to a wide variety of pathogens, but the rapidity and severity of his clinical presentation made L. monocytogenes and HSV-1 encephalitis the most likely diagnostic possibilities. The CSF Gram stain was negative, but the elevated CSF lactic acid levels with encephalitis and red blood cells in the CSF indicated L. monocytogenes as the most likely pathogen. We present a case of L. monocytogenes encephalitis mimicking HSV-1 encephalitis. While receiving ampicillin therapy, the patient remained unresponsive for more than 1 week and then suddenly regained consciousness and recovered without neurologic sequelae.
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Affiliation(s)
- Burke A Cunha
- Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, 11501, USA
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44
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Mizuno S, Zendejas IR, Reed AI, Kim RD, Howard RJ, Hemming AW, Schain DC, Soldevila-Pico C, Firpi RJ, Fujita S. Listeria monocytogenes following orthotopic liver transplantation: Central nervous system involvement and review of the literature. World J Gastroenterol 2007; 13:4391-3. [PMID: 17708617 PMCID: PMC4250870 DOI: 10.3748/wjg.v13.i32.4391] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Listeria monocytogene is a well-recognized cause of bacteremia in immunocompromised individuals, including solid organ transplant recipients, but has been rarely reported following orthotopic liver transplantation. We describe a case of listeria meningitis that occurred within a week after liver transplantation. The patient developed a severe headache that mimicked tacrolimus encephalopathy, and was subsequently diagnosed with listeria meningitis by cerebrospinal fluid culture. The infection was successfully treated with three-week course of intravenous ampicillin. Recurrent hepatitis C followed and was successfully treated with interferon alfa and ribavirin. Fourteen cases of listeriosis after orthotopic liver transplantation have been reported in the English literature. Most reported cases were successfully treated with intravenous ampicillin. There were four cases of listeria meningitis, and the mortality of them was 50%. Early detection and treatment of listeria meningitis are the key to obtaining a better prognosis.
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Affiliation(s)
- Shugo Mizuno
- Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Florida College of Medicine, PO Box 100286, Gainesville, FL 32610-0286, United States
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45
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Tsai SH, Chu SJ, Wu CP, Wang NC. Listerial meningitis in a patient with undiagnosed acquired immunodeficiency syndrome: ampicillin should be added to the empirical antibiotic coverage. Emerg Med J 2007; 23:e50. [PMID: 16921071 PMCID: PMC2564238 DOI: 10.1136/emj.2006.036152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Meningitis is an important differential diagnosis in patients with fever, headache, and/or altered consciousness in the emergency department (ED). With human immunodeficiency virus (HIV) infection becoming increasingly common, patients with acquired immunodeficiency syndrome (AIDS) need to be recognised promptly to facilitate the choice of appropriate antibiotic therapy for potential opportunistic infections. Physicians should be able to recognise a patient with undiagnosed AIDS who presents to the ED and perform further confirmational tests without violating the rights of the patient. Additional tests focusing on discovering potential opportunistic pathogens should be performed. Ampicillin should be added to the empirical regimen for the coverage of Listeria meningocerebritis, which should be considered in all potentially immunocompromised hosts with suggestive clinical presentations. Failure to recognise patients with AIDS and provide antibiotics active against L monocytogenes in such hosts may lead to a catastrophic outcome.
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Affiliation(s)
- S-H Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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46
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Patil AB, Nadiger S, Chandrasekhar MR, Halesh LH, Kumar M. Listeria monocytogenes meningitis: an uncommon opportunistic infection in HIV/AIDS. INDIAN J PATHOL MICR 2007; 50:671-3. [PMID: 17883181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE To report an interesting case of meningitis caused by Listeria monocytogenes meningitis in an HIV seropositive individual. MATERIALS & METHODS A previously healthy 45 years old HIV seropositive man, presented with atypical clinical features of meningitis. Blood and Cerebrospinal fluid (CSF) were obtained for biochemical and microbiological investigations. RESULTS CSF analysis showed pleocytosis with lymphocytic predominance. Gram stain of CSF was negative; however culture yielded growth of gram positive bacilli with tumbling motility. Based on relevant biochemical tests the isolate was identified as Listeria monocytogenes. Patient was treated with i.v. ampicillin and recovered completely. CONCLUSION Listeriosis is relatively rare in HIV/AIDS among the immunodeficient populations. Atypical clinical and laboratory findings make the diagnosis difficult and these infections may go undiagnosed. Since it is easily treated with readily available antibiotics, it is important to diagnose them at the earliest and thereby prevent treatment failure.
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Affiliation(s)
- Asha B Patil
- Department of Microbiology, Karnataka Institute of Medical Sciences, Hubli.
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47
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48
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Radice C, Muñoz V, Castellares C, Casanova M, Serrano D, Carrión R, Balsalobre P, Buño I, Díez-Martín JL. Listeria monocytogenes meningitis in two allogeneic hematopoietic stem cell transplant recipients. Leuk Lymphoma 2006; 47:1701-3. [PMID: 16966293 DOI: 10.1080/10428190600648135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
MESH Headings
- Adult
- Anemia, Refractory, with Excess of Blasts/complications
- Anemia, Refractory, with Excess of Blasts/therapy
- Drug Resistance, Bacterial
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/therapy
- Male
- Meningitis, Listeria/diagnosis
- Meningitis, Listeria/etiology
- Middle Aged
- Transplantation, Homologous
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Nishida Y, Komachi H, Mizusawa H. A case of Listeria meningitis associated with increased adenosine deaminase in cerebrospinal fluid. Diagn Microbiol Infect Dis 2006; 57:435-7. [PMID: 17141462 DOI: 10.1016/j.diagmicrobio.2006.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2006] [Revised: 09/11/2006] [Accepted: 09/17/2006] [Indexed: 11/19/2022]
Abstract
We present, to the best of our knowledge, the first case of listeria meningitis with increased adenosine deaminase (ADA) in cerebrospinal fluid. Although some cases of other etiologies were also reported, this report informs those who manage patients with meningitis that not only Mycobacterium and Brucella spp. but also other facultative agents can increase ADA levels in cerebrospinal fluid, possibly through monocyte-macrophage activation.
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Affiliation(s)
- Yoichiro Nishida
- Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
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50
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Thabet F, Tilouche S, Tabarki B, Boukadida J, Yacoub M, Essoussi AS. [Listeria monocytogenes meningitis in an immunocompetent child]. Arch Pediatr 2006; 13:1553-4. [PMID: 17029934 DOI: 10.1016/j.arcped.2006.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Accepted: 09/05/2006] [Indexed: 11/25/2022]
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