ABSTRACT
Introducción: La listeriosis es una patología de baja incidencia, con síntomas leves y autolimitados en la población en general, sin embargo, la transmisión materno-fetal, puede generar cuadros graves en neonatos, manifestados como sepsis, meningitis, endocarditis, encefalitis, meningoencefalitis. El diagnóstico oportuno por clínica y datos de laboratorio en coyuntura con la terapéutica adecuada favorecen la resolución de la enfermedad. Caso clínico: Neonato prematuro tardío de 34 semanas, 6 días de edad gestacional, nació por cesárea iterativa, al nacimiento no vigoroso con líquido amniótico meconial pesado, requirió reanimación básica y avanzada. Evolución: Por los antecedentes natales se realizó estudio de infección, con reporte positivo y desarrollo en hemocultivos de Listeria Monocytogenes, diagnóstico de sepsis, meningitis y conjuntivitis, recibió antibiótico terapia intrave-nosa, completó tratamiento y presentó evolución clínica favorable. Conclusiones: En el presente caso la listeriosis de transmisión materno-neonatal tuvo una presentación grave con aspiración de líquido meconial que requirió intubación y soporte ventilatorio, el paciente desarrolló meningitis y conjuntivitis. En la placenta se presentó corionitis.
Introduction: Listeriosis is a low-incidence pathology with mild and self-limiting symptoms in the general population; however, maternal-fetal transmission can generate severe conditions in neonates, manifested as sepsis, meningitis, endocarditis, encephalitis, meningoencephalitis. Timely diagnosis by clinical and laboratory data in conjunction with adequate therapy favors the resolution of the disease. Clinical case: Late preterm neonate of 34 weeks, six days of gestational age, was born by repetitive cesarean section at non-vigorous birth with heavy meconium amniotic fluid and required basic and advanced resuscitation. Evolution: Based on the birth history, an infection study was carried out, with a favorable report and development of Listeria Monocytogenes in blood cultures, diagnosis of sepsis, meningitis, and conjunctivitis, received intravenous antibiotic therapy, completed treatment, and presented favorable clinical evolution. Conclusions: In the present case, the listeriosis of maternal-neonatal transmission had a severe presentation with the aspiration of meconium fluid that required intubation and ventilatory support; the patient developed meningitis and conjunctivitis. Chorionitis occurs in the placenta.
Subject(s)
Humans , Infant, Newborn , Infant, Newborn , Listeriosis , Meningitis, Listeria , Listeria monocytogenes , MeconiumABSTRACT
Resumen Listeria monocytogenes es una bacteria grampositiva, considerada oportunista, que produce enfermedad en huéspedes susceptibles y excepcionalmente en pacientes inmunocompetentes. Se incluye dentro de las enfermedades trasmitidas por alimentos (ETA). Su importancia radica en la dificultad diagnóstica, la alta mortalidad pese a la sensibilidad de la bacteria a la ampicilina, y a las medidas de prevención que pueden evitar la transmisión al hombre. Presentamos el caso clínico de una niña de 9 años previamente sana que cursó una infección grave y de evolución fatal.
Summary Listeria monocytogenes is a gram-positive opportunistic bacteria that can cause a disease in vulnerable hosts and exceptionally, in immunocompetent patients. The infection caused by it is included in the foodborne diseases group. The condition is relevant given its diagnostic difficulties and its high mortality, in spite of it being sensitive to ampicillin and the prophylactic measures defined to avoid it being transmitted to humans. The study presents the case of a previously healthy 9 year old girl, who suffered a severe infection and died.
Subject(s)
Humans , Meningitis, Listeria/diagnosis , Catastrophic Illness , Foodborne Diseases , Meningitis, ListeriaABSTRACT
Introduction : La cryptococcose neuro-méningée est la plus commune des affections mortelles du Système Nerveux Central chez les patients immuno-déprimés en Afrique Subsaharienne. Il s'agit alors d'une véritable urgence diagnostique et thérapeutique, d'où la mise en Åuvre des tests diagnostiques rapides et efficace. Le Crag-Test serum (Antigénémie cryptococcique) pourrait alors se révéler utile sur ces terrains particuliers en milieu rural africain. Observation : Nous rapportons deux cas de cryptococcose neuro-méningée chez deux patientes âgées respectivement de 48 et 38 ans au regard du terrain d'immuno-dépression acquis, la présence de levure encapsulée à l'examen du liquide cérébro-spinal à l'encre de Chine dans un cas et la positivité du Crag-test serum dans les deux cas. La présence d'emblée de facteurs de mauvais pronostic expliquaient l'issue fatale. Conclusion : Compte tenu de la gravité potentielle de cette affection, le Crag-test serum devrait être facilement accessible et disponible pour un diagnostic rapide et une prise en charge précoce et efficace afin de limiter la morbi-mortalité
Subject(s)
Gabon , Meningitis, Cryptococcal/diagnosis , Meningitis, Listeria , Rural PopulationABSTRACT
BACKGROUND AND PURPOSE: Encephalitis caused by Listeria monocytogenes (L. monocytogenes) is rare but sometimes fatal. Early diagnosis is difficult using routine cerebrospinal fluid (CSF) tests, while next-generation sequencing (NGS) is increasingly being used for the detection and characterization of pathogens. METHODS: This study set up and applied unbiased NGS to detect L. monocytogenes in CSF collected from three cases of clinically suspected listeria meningoencephalitis. RESULTS: Three cases of patients with acute/subacute meningoencephalitis are reported. Magnetic resonance imaging and blood cultures led to a suspected diagnosis of L. monocytogenes, while the CSF cultures were negative. Unbiased NGS of CSF identified and sequenced reads corresponding to L. monocytogenes in all three cases. CONCLUSIONS: This is the first report highlighting the feasibility of applying NGS of CSF as a diagnostic method for central nervous system (CNS) L. monocytogenes infection. Routine application of this technology in clinical microbiology will significantly improve diagnostic methods for CNS infectious diseases.
Subject(s)
Humans , Central Nervous System , Cerebrospinal Fluid , Communicable Diseases , Diagnosis , Early Diagnosis , Encephalitis , Listeria monocytogenes , Listeria , Magnetic Resonance Imaging , Meningitis, Listeria , Meningoencephalitis , MethodsABSTRACT
Listeria meningoencephalitis is a rare condition, occurring mainly in immunocompromised patients. We present two cases of Listeria monocytogenes meningoencephalitis in immunocompetent children, with successful treatment with betalactam/aminoglycoside combination. Unpasteurized cheese was postulated as the source of infection.
La meningoencefalitis por Listeria spp. es una infección infrecuente, principalmente en pacientes con algún tipo de inmunosupresión. Presentamos dos casos clínicos de meningitis por Listeria monocytogenes en niñas inmunocompetentes con tratamiento exitoso con β lactámicos combinados con aminoglucósidos; se identificó la ingesta de queso no pasteurizado como probable fuente de infección.
Subject(s)
Child, Preschool , Female , Humans , Infant , Cheese/poisoning , Foodborne Diseases/microbiology , Immunocompetence , Meningitis, Listeria/etiology , Pasteurization , Aminoglycosides/therapeutic use , Cheese/microbiology , Meningitis, Listeria/drug therapy , beta-Lactamase Inhibitors/therapeutic use , beta-Lactams/therapeutic useABSTRACT
Listeria monocytogenes (L. monocytogenes) is an uncommon cause of bacterial meningitis in immunocompetent adults. Patients with immunosuppression are at increased risk of developing serious invasive diseases, particularly meningitis. We describe a case of meningitis caused by L. monocytogenes in an immunocompetent and previously healthy 34-year-old adult. The patient received treatment with intravenous ampicillin plus amikacin and made a full recovery. L. monocytogenes should be suspected in immunocompetent adults with bacterial meningitis who fail to respond to empirical antibiotic treatment.
Listeria monocytogenes (L. monocytogenes) é uma causa rara de meningite bacteriana em adultos imunocompetentes. Pacientes com imunossupressão têm maior risco de desenvolver graves doenças invasivas, especialmente a meningite. Descrevemos um caso de meningite por L. monocytogenes em um adulto imunocompetente e previamente sadio com idade de 34 anos. O paciente recebeu tratamento com ampicilina intravenosa mais amicacina e fez uma recuperação completa. L. monocytogenes deve ser suspeitada em imunocompetentes adultos com meningite bacteriana que não respondem ao tratamento antibiótico empírico.
Subject(s)
Adult , Humans , Male , Amikacin/therapeutic use , Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Meningitis, Listeria/diagnosis , Drug Therapy, Combination , Immunocompetence , Meningitis, Listeria/drug therapyABSTRACT
São descritos sete casos de doença neurológica em ovinos por Listeria monocytogenes no Rio Grande do Sul e Paraná entre 2000 e 2007. Foram afetados ovinos com idades entre 12-24 meses. Os casos ocorreram no verão e início da primavera e os índices gerais de morbidade e letalidade foram de 3,15 por cento e 100 por cento, respectivamente. Quando essa informação estava disponível, nenhum dos ovinos afetados era alimentado com silagem. Em três propriedades havia contato próximo dos ovinos afetados com outras espécies. A evolução do quadro clínico foi de 12 horas a três dias e os sinais clínicos foram caracterizados por decúbito (7/7), desvio da cabeça (4/7), incoordenação (3/7), depressão (3/7), andar em círculos (2/7), cegueira unilateral, emagrecimento progressivo, febre, midríase, movimentos de pedalagem, nistagmo lateral, opistótono, paralisia flácida dos membros pélvicos ou dos quatro membros, salivação excessiva e tremores (1/7 cada). Histologicamente observou-se encefalite com microabscessos, predominantemente unilateral com variáveis graus de gliose e alterações degenerativas como esferóides axonais e infiltração de células Gitter. As lesões se estendiam desde a medula oblonga até o mesencéfalo. Antígenos de Listeria monocytogenes foram detectados por imuno-histoquímica em seções de tronco encefálico de todos os ovinos afetados. O diagnóstico foi realizado com base nos achados epidemiológicos e clinico-patológicos, e confirmado pela imuno-histoquímica (IHQ) utilizando anticorpo policlonal anti-L. monocytogenes.
Seven cases of neurological disease in sheep caused by Listeria monocytogenes in Rio Grande do Sul and Paraná state, southern Brazil are described. The cases occurred between 2000 and 2007 and 12-24-month-old sheep were affected. Overall morbidity and lethality rates were 3.15 percent and 100 percent, respectively. Cases occurred in the summer and early spring. When this information was available, affected sheep had not been fed with silage. In three farms there were close contact among affected sheep and other species. Clinical signs were characterized by recumbency (7/7), head tilt (4/7), incoordination (3/7), depression (3/7), circling (2/7), unilateral blindness, wasting, fever, midriasis, paddling, opisthotonus, hind or hind and fore limb paralysis, drooling, and muscle tremors (1/7 each). Clinical evolution varied from 12 hours to three days. Histological findings consisted of predominantly unilateral, microabscedative encephalitis with variable degrees of gliosis and degenerative lesions characterized by axonal spheroids and infiltration by Gitter cells. These lesions were observed extending from medulla oblongata to mesencephalon. Listeria monocytogenes antigen was showed by imunohistochemistry in routinely processed sections of brainstem from all seven affected sheep. The diagnostic was based on epidemiological, clinical, and pathological findings and confirmed by immunohistochemistry (IHQ) using polyclonal anti-L. monocytogenes antibody.
Subject(s)
Animals , Listeriosis/pathology , Listeriosis/veterinary , Meningitis, Listeria/diagnosis , Meningitis, Listeria/physiopathology , Immunohistochemistry , Listeria monocytogenes , SheepABSTRACT
The case of a woman with systemic lupus erythematosus and coexistent milky ascites and meningitis by Listeria monocytogenes is reported. The patient was under longstanding immunosuppressive treatment. Listeriosis is considered an uncommon condition in adults, which occurs as opportunistic infection in immunosuppressed hosts. Samples from ascites showed low triglyceride concentration. Opalescent ascites and Listeria meningitis are rarely reported inpatients with systemic lupus erythematosus.
Relata-se o caso de uma mulher com lúpus eritematoso sistêmico e ascite leitosa coexistente com meningite por Listeria monocytogenes. A paciente estava em tratamento imunossupressivo de longa duração. A listeriose é considerada doença incomum em adultos, que ocorre como infecção oportunista em hospedeiros imunossuprimidos. Amostras da ascite revelaram baixa concentração de triglicérides. Ascite opalecente e meningite por Listeria são raramente descritas em pacientes com lúpus eritematoso sistêmico.
Subject(s)
Humans , Female , Middle Aged , Ascites , Immunosuppression Therapy , Listeria monocytogenes , Lupus Erythematosus, Systemic , Meningitis, ListeriaABSTRACT
Infection still remains a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). Patients with SLE are well known to have an increased risk of various opportunistic infections, which can be fatal. Central nervous system (CNS) infections such as meningitis are rare complications to SLE. On occasion, nonspecific neurologic manifestations of infectious meningitis in SLE patients can be confused with neuropsychiatric lupus. Listeria monocytogenes is a less-commonly identified organism causing meningitis in SLE patients. Here, we describe a case of Listeria monocytogenes meningitis presenting with bilateral abducens nerve (sixth cranial nerve) palsy in a patient with SLE, who was successfully treated with systemic antibiotics.
Subject(s)
Humans , Abducens Nerve , Abducens Nerve Diseases , Anti-Bacterial Agents , Central Nervous System , Listeria , Listeria monocytogenes , Lupus Erythematosus, Systemic , Meningitis , Meningitis, Listeria , Neurologic Manifestations , Opportunistic Infections , ParalysisABSTRACT
Listeria Monocytogenes is a gram-positive Bacillus that affects immunocompromised patients, newborn, pregnant women and persons over 65 years. Infection is acquired through contaminated food. The Bacillus has predilection for the central nervous system. Its presents most commonly as an acute meningitis, it also presents as a chronic meningitis, cerebritis, rhomboencephalitis, brain and spinal abscess. Diagnosis for L. monocytogenes is made through positive cultures in blood and cerebrospinal fluid (CSF). Magnetic Resonance (MR) also helps to in the diagnosis of neurolisteriosis lesions. We described seven cases with L. Monocytogenes infection during 2007 and 2008, with four cases over the aged of 65 years old. Five presented acute meningitis; two rhomboencephalitis and one patient had meningoencephalitis. Six cases showed inflammatory CSF with pleocytosis with polymorphonuclear prevail and normal glycorrachia. MR showed inflammatory findings in five patients and focal brainstem lesions in two cases, one had acute hydrocephalus due arachnoiditis. Five patients improve clinically and two fatal cases were described. Listeriosis is the third cause of meningitis and should be consider in the differential diagnosis of meningitis with clear fluid, especially with pleocytosis and normal glycorrachia. Other clues of the diagnosis are dizziness with or without nystagmus and brainstem compromise. Arachnoiditis should be avoided with steroidal use. The diagnostic imaging test of choice for brain stem compromise is MR.
La Listeria Monocytogenes es un bacilo Gram-positivo que afecta a pacientes inmunocomprometidos, a niños, embarazadas y personas mayores de 65 años. El modo de adquirirla es la ingestión de alimentos contaminados. El bacilo tiene predilección por el sistema nervioso central, donde su expresión más frecuente es la meningitis aguda, también puede presentarse como meningitis crónica, cerebritis, rombencefalitis, abscesos cerebrales y espinales. El cultivos positivos de L. monocytogenes en muestras de sangre o líquido cefalorraquídeo, permite confirmar el diagnóstico. La Resonancia Magnética de cerebro también contribuye al diagnóstico de las lesiones por neurolisteriosis. Se analizan siete casos de neurolisteriosis ocurridos los a±os 2007 y 2008, entre ellos cuatro pacientes mayores de 65 años. La meningitis aguda fue la forma de presentación en cinco de ellos, dos evolucionaron como rombencefalitis y uno como meningoencefalitis. El LCR fue inflamatorio en seis de los pacientes, con pleocitosis depredominio polinuclear, pero glucorraquia normal. La RM mostró imágenes de aspecto inflamatorio en cinco de los enfermos, dos de ellos tenían lesiones focales del tronco cerebral, uno hizo un hidrocéfalo agudo por aracnoiditis. Cinco pacientes presentaron una evolución clínica favorable y dos fallecieron. Siendo la listeriosis la tercera causa etiológica de meningitis, debe ser considerada en el diagnóstico diferencial de meningitis a líquido claro, especialmente en LCR con abundantes polinucleares y glucosa en rangos normales. Otras claves son la sensación vertiginosa con o sin nistagmus y el compromiso de nervios craneales de origen protuberancial. Debe prevenirse las aracnoiditis con el uso precoz de corticoides. Es obligatorio el estudio con RM en toda sospecha de neurolisteriosis.
Subject(s)
Humans , Male , Adolescent , Female , Middle Aged , Meningitis, Listeria/diagnosis , Meningitis, Listeria/etiology , Meningitis, Listeria/drug therapy , Acute Disease , Anti-Bacterial Agents/therapeutic use , Clinical Evolution , Cerebrospinal Fluid/microbiologyABSTRACT
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.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Ampicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Culture Media , HIV Infections/complications , Humans , Listeria monocytogenes/isolation & purification , Male , Meningitis, Listeria/diagnosis , Middle Aged , Treatment OutcomeABSTRACT
L.monocytogenes es un cocobacilo Gram positivo, no esporulado, anaerobio facultativo, que se encuentra ampliamente distribuido en la naturaleza y crece en un amplio rango de temperatura (-0.4 C a 50 C), y constituye una causa importante de infección, en especial en mujeres embarazadas, recién nacidos e inmunosuprimidos, causando bacteriemia y meningitis en estos pacientes. En pediatría la L. monocytogenes está dentro de las tres principales causas de meningitis neonatal y se presenta como una infección temprana, hasta el tercer día de nacido, comportándose como un cuadro clínico de sepsis neonatal temprana. La listeriosis neonatal de presentación tardía es menos común. Se presenta en recién nacidos a término, después de la segunda semana de vida y cursa como una meningitis. Posterior al período neonatal, 30-50 por ciento de los pacientes presenta un cuadro clínico de meningitis, asociada a inmunosupresión
Subject(s)
Listeria monocytogenes , Meningitis, ListeriaABSTRACT
We report a 43-year old woman of Listeria monocytogenes bacteremia associated with systemic lupus erythematosus (SLE). She had been treated with glucocorticoid pulse therapies and a cyclophosphamide pulse therapy for relapsed lupus nephritis class IV. After the immunosuppressive treatment, she complained of fever, vomiting, diarrhea, and abdominal pain. Diffuse edematous thickening of bowel wall was seen on abdominal CT scan and Listeria monocytogenes was identified on blood culture study. After antibiotic therapy that lasted for more than 4 weeks, her presenting symptoms were resolved and no more Listeria monocytogenes was identified on follow-up culture studies. Infection with Listeria monocytogenes, a rare food-borne illness, can be life-threatening with high fatality rates and is known to occur more frequently in immunocompromised patients, including those receiving high-dose glucocorticoid or immunosuppressive therapy for collagen vascular disease. In Korea, a case of Listeria meningitis was reported, but a case of bacteremia caused by Listeria monocytogenes enteritis has never been reported in SLE patients. Thus, we report a case of Listeria monocytogenes bacteremia that occurred due to food poisoning after aggressive immunosuppressive treatment in a patient with SLE.
Subject(s)
Adult , Female , Humans , Abdominal Pain , Bacteremia , Collagen , Cyclophosphamide , Diarrhea , Enteritis , Fever , Follow-Up Studies , Foodborne Diseases , Immunocompromised Host , Korea , Listeria monocytogenes , Listeria , Lupus Erythematosus, Systemic , Lupus Nephritis , Meningitis, Listeria , Tomography, X-Ray Computed , Vascular Diseases , VomitingABSTRACT
Since it has been named as Listeria monocytogenes after its detection in 20th century, listeriosis has been known as a microorganism to parasitize and proliferate in cytoplasm of eucaryotic cell in many researches. As listeriosis has been occurred frequently in malignancy, leukemia, alcoholism, pregnant women, neonates and patients who has been administered immunosuppressants, a declined cell- mediated immune system of these patients has gotten the clinical attention as a common pattern. Infections by listeria have been rarely reported in end stage renal disease patients with a reduction in cell- medicated immune system. Through our experience, we'd like to report a meningitis by Listeria monocytogenes which has not been submitted in Korea yet.
Subject(s)
Female , Humans , Infant, Newborn , Alcoholism , Cytoplasm , Immune System , Immunosuppressive Agents , Kidney Failure, Chronic , Korea , Leukemia , Listeria monocytogenes , Listeria , Listeriosis , Meningitis , Meningitis, Listeria , Pregnant Women , Renal DialysisABSTRACT
Listeria monocytogenes is the causative agent in a spectrum of human disease ranging from gastroenteritis to invasive infections such as meningitis, encephalitis, and septicemia. Elderly patients or persons who have lower cell-mediated immunity with predisposing conditions such as transplants, lymphomas, and AIDS, are especially susceptible. The tropism of L.monocytogenes for the central nervous system leads to severe disease, often with high mortality. We report a case of L. monocytogenes meningitis in a 58-year old woman with end stage renal disease. The patient was discharged without neurological sequelae after antibiotic treatment.
Subject(s)
Aged , Female , Humans , Middle Aged , Central Nervous System , Encephalitis , Gastroenteritis , Immunity, Cellular , Kidney Failure, Chronic , Listeria monocytogenes , Listeria , Lymphoma , Meningitis , Meningitis, Listeria , Mortality , Sepsis , TropismABSTRACT
Relato do primeiro caso, em Campina Grande-PB, Brasil, de isolamento e identificaçäo laboratorial de listeria monocytogenes, sorovar 1b, em um paciente adulto, do sexo masculino, sem história de comprometimento imunológico e apresentando sintomas clínicos de meningite (febre, cefaléia e rigidez da nuca). O antibiograma realizado pelo método de difusäo em discos apresentou sensibilidade para 8 (42,1 porcento) dos 19 antimicrobianos testados. A cepa estudada apresentou-se sensível para:amicacina, ceftriaxona, gentamicina, lomefloxacina, netilmicina, tetraciclina, tobramicina e vancomicina. O paciente recebeu alta após 10 dias de antibioticoterapia com ceftriaxona sem apresentar seqüelas
Subject(s)
Humans , Male , Ceftriaxone , Listeria monocytogenes , Meningitis, Listeria , Signs and Symptoms , Anti-Bacterial Agents , Microbial Sensitivity Tests , Tetracycline , VancomycinABSTRACT
In systemic lupus erythematosus (SLE) patients, immunosuppressive treatment with cytotoxic drugs or corticosteroids, proteinuria, renal insufficiency, and active SLE itself are known as risk factors for serious bacterial infections and opportunistic infections. Several opportunistic infections such as toxoplasmosis, nocardiosis, and cryptococcal meningitis have been reported to occur in patients with SLE and these can mimic neuropsychiatric lupus. Listeria monocytogenes is one of the pathogens of bacterial meningitis that is less commonly identified than Neisseira meningitidis and Streptococcus pneumoniae in adults, and shows the clinical manifestations, such as headache, fever, nausea, vomiting, neck stiffness, mental changes and seizures similar to symptoms and signs of neuropsychiatric lupus. We report a case of Listeria monocytogenes meningitis in a patient with SLE who was admitted because of headache, nausea, vomiting and poor oral intake.
Subject(s)
Adult , Humans , Adrenal Cortex Hormones , Bacterial Infections , Fever , Headache , Listeria monocytogenes , Listeria , Lupus Erythematosus, Systemic , Meningitis, Bacterial , Meningitis, Cryptococcal , Meningitis, Listeria , Nausea , Neck , Nocardia Infections , Opportunistic Infections , Proteinuria , Renal Insufficiency , Risk Factors , Seizures , Streptococcus pneumoniae , Toxoplasmosis , VomitingABSTRACT
Listeria monocytogenes, um bacilo Gram-positivo, asporogênico, tem sido isolada de mamíferos, aves, peixes, crustáceos e insetos, sendo seu habitat primário, o solo e vegetal em decomposiçäo. Causa infecçäo no homem e animais domésticos. Em humanos ocorre em maior incidência em recém-nascidos e indivíduos acima de 60 anos, sendo a meningite uma manifestaçäo comum de listeriose. De cinco crianças recém-nascidas no mesmo Centro Obstérico de um hospital da Grande Säo Paulo, foi isolada Listeria monocytogenes do líquido cefalorraquidiano (LCR). Todas as cepas pertenceram ao mesmo sorotipo, L4b. Foi analisada a resistência destas cepas a antibacterianos. As mäes de 6 crianças nascidas no período de 14.05 horas, das quais uma foi óbito sem ter sido puncionado o LCR, tiveram colhidas fezes e urina. Destes materiais näo foi isolado o microrganismo
Subject(s)
Meningitis, Bacterial/epidemiology , Listeria monocytogenes/isolation & purification , Disease Outbreaks , Serotyping , Cerebrospinal Fluid , Meningitis, Listeria/cerebrospinal fluid , Meningitis, Listeria/epidemiology , Drug Resistance, MicrobialABSTRACT
Listeriosis in a healthy child is extremely rare. A previously healthy 9-year-old male was admitted with pyrexia, headache and lethargy. The CSF cultures, taken on admission and on the 5th day, showed growth of Listeria monocytogenes. L. monocytogenes was identified by various methods, including polymerase chain reaction(PCR). Serologically, it showed type 1/2a. However, blood cultures, which were taken on the same days, revealed no growth of L. monocytogenes. Ceftriaxone and amikacin had no effect on the progress of the disease. The combination of ampicillin plus gentamicin, which is regarded as the treatment of choice for L. monocytogenes infection, had an effect in this case. Patient showed severe neurological symptoms and signs, such as diplopia, esotropia, nystagmus, ptosis and other meningeal signs during the hospital days, even though all such symptoms and signs were improved at discharge. We report the case with brief review of related literatures.