1/70. Listeria meningitis in children: report of two cases.We report two cases of meningitis caused by listeria monocytogenes in children. The first patient was a healthy 14-month-old boy and the second patient a 3-year-old girl with Byler disease which, however, is not reported as a predisposing factor for listeriosis. We present these cases because Listeria infection, although common in neonates, is extremely infrequent during infancy and childhood.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/70. trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia.A 5-year-old boy with acute lymphoblastic leukemia (ALL) and intolerance to oral trimethoprim-sulfamethoxazole (TMP/SMX) had listeria monocytogenes bacteremia and meningitis develop during maintenance chemotherapy. Despite prompt administration of IV amoxicillin/gentamicin and microbiologic clearance of the bloodstream, the patient had no response to therapy after a course of 7 days. Intravenous TMP/SMX (10 mg/kg per day of TMP) was added to the antibiotic regimen after desensitization. fever and meningeal signs rapidly resolved, and the patient was ultimately cured. amoxicillin and gentamicin, although highly active and synergistic in vitro against L. monocytogenes, have limited intracellular penetration and activity. In contrast, TMP/SMX has bactericidal extracellular and intracellular activity against Listeria and excellent central nervous system penetration, and thus may be effective for the treatment of refractory listeriosis.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
3/70. Neurolisteriosis presenting as recurrent transient ischemic attacks.An elderly man experienced recurrent transient episodes of right arm weakness and expressive aphasia. He was initially treated with aspirin and then with coumadin. Thirteen days after initial presentation, he became febrile and had signs of meningitis. The illness progressed relentlessly to death 9 weeks after admission to the hospital. Necropsy showed prominent meningitis with vasculitis extending into the left frontal lobe. polymerase chain reaction identified the organism as listeria monocytogenes.- - - - - - - - - - ranking = 0.4keywords = meningitis (Clic here for more details about this article) |
4/70. Listeria meningoencephalitis: two cases and a review of the literature.INTRODUCTION: Although presently uncommon locally, Listeria is increasing an important cause of central nervous system (CNS) infection worldwide. It differs from the common meningitis pathogens in its clinical features and treatment. CLINICAL PICTURE: We present 2 recently encountered cases of Listeria meningoencephalitis. In case 1, a previously healthy 42-year-old man presented with clinical features of meningoencephalitis. In case 2, a 64-year-old woman had clinical features of pneumonia and meningoencephalitis. Both had a predominantly lymphocytic picture in their cerebrospinal fluid (CSF) samples. Listeria grew in blood cultures of both patients and the CSF culture of the first. TREATMENT: In both cases, Listeria was resistant to the empirical antibiotics used. Intravenous ampicillin was eventually used in both patients, with gentamicin, added for synergistic action in the first. OUTCOME: The first patient developed complications of hydrocephalus, subdural collection and extensive cerebritis and ventriculitis. The second patient had focal seizures and a pontine infarct. Both did not survive. CONCLUSION: These 2 recent cases with different presentations of intracranial listerosis highlight the increasing importance of listerial infections in singapore. Clinicians need to be familiar with the features of this lethal disease in order to recognize and manage it successfully.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
5/70. Early-onset listeriosis in prematurity.listeria monocytogenes has been recognized as a human pathogen for more than 70 years. It causes illness mainly in pregnant women, newborns, elderly, and immunocompromised persons. Although L. Monocytogenes is a relatively uncommon pathogen in neonates, it can cause considerable morbidity and mortality in this age group, especially in the early-onset form of the disease. In taiwan, neonatal listeriosis is rarely reported. We report one case of a premature newborn with early-onset listeria sepsis and meningitis.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
6/70. listeriosis and AIDS: case report and literature review.listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in hiv-infected patients. This scarcity of reported cases has aroused interest in the association of listeriosis and AIDS. In this paper we present a case of meningitis and septicemia caused by listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems. Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
7/70. Listerial meningitis. Which patients are vulnerable?The physician's index of suspicion for infection with listeria monocytogenes should be elevated if a patient presents with symptoms of meningitis and has impaired cell-mediated immunity. Although diagnosis is aided by detection of an elevated white blood cell count and protein level in the cerebrospinal fluid, it requires isolation of the organism from the cerebrospinal fluid. Appropriate antibiotic treatment leads to recovery in most cases.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
8/70. Listeria meningitis associated with infliximab.OBJECTIVE: To report a case of listeria monocytogenes meningitis in a 73-year-old man receiving infliximab for rheumatoid arthritis. CASE SUMMARY: A 73-year-old white man taking infliximab for rheumatoid arthritis developed listeria meningitis following his second dose. He was receiving other immunosuppressants; however, these remained constant immediately prior to the infection. diagnosis was confirmed with L. monocytogenes isolated in the cerebrospinal fluid. The patient received 21 days of antibiotic therapy and recovered without any complications. DISCUSSION: L. monocytogenes is a gram-positive, non-spore-forming rod that has been associated with the ingestion of undercooked foods. This organism can cause sepsis or meningitis; however, immunocompromised patients, elderly patients, pregnant women, and neonates appear to be at greater risk for this type of infection. Tumor-necrosis factor-alpha (TNF-alpha) plays an important role in resistance to this type of infection, and listeria infections have been reported in 26 patients receiving TNF-alpha inhibitors. In our patient, the listeria infection occurred following his second course of infliximab, which provides a temporal relationship between the listeria infection and infliximab. However, his underlying rheumatoid arthritis and chronic steroid therapy would also increase his risk for a listeria infection. CONCLUSIONS: The listeria infection in our patient was a possible adverse event of infliximab according to the Naranjo probability scale. Because the majority of listeria infections occur in patients who are immunosuppressed, it would be reasonable to provide education for healthcare professionals on preventing these infections in all patients receiving immunosuppressants, including anti-TNF-alpha therapy. Those at risk due to their underlying health conditions should also be monitored closely.- - - - - - - - - - ranking = 1.4keywords = meningitis (Clic here for more details about this article) |
9/70. Fulminant listeria monocytogenes meningitis complicated with acute hydrocephalus in healthy children beyond the newborn period.We describe 3 previously healthy Costa Rican children who had listeria monocytogenes meningitis, an uncommon cause of bacterial meningitis beyond the newborn period in normal subjects. Two of them had initial normal brain computed tomography, but all 3 developed acute hydrocephalus at days 7, 3, and 5, respectively. All required immediate ventriculostomy placement and only 1 of 3 survived. L. monocytogenes should be considered among the etiologies of bacterial meningitis in children who do not respond initially to conventional antimicrobial treatment or who deteriorate rapidly.- - - - - - - - - - ranking = 1.4keywords = meningitis (Clic here for more details about this article) |
10/70. Fatal meningitis due to listeria monocytogenes in elderly patients with underlying malignancy.adult patients with malignancies are considered to be at a high risk for listeria monocytogenes meningitis. The microbiology Laboratory's database of the University Hospital of Ioannina, greece, was searched for cases of L. monocytogenes during the period from January 1990 to December 2002. Listerial meningitis occurred in three patients: one with brain tumour, one with chronic lymphocytic leukaemia, and one with non-Hodgkin's lymphoma. All the patients were older than 70 and they were actively receiving therapy for their malignancy. L. monocytogenes type 4b was isolated from blood and cerebrospinal fluid. All were treated with ampicillin and gentamicin, but they died shortly after the initiation of the treatment. Experience with the three present cases indicated the high mortality rate due to listerial meningitis in this immunosuppressed population. So, listeriosis should be suspected in patients with meningitis and underlying malignancy. Since meningitis due to L. monocytogenes is not distinguishable clinically from other types of bacterial meningitis, it is recommended to cover Listeria in the initial empirical therapy of bacterial meningitis in immunosuppressed patients.- - - - - - - - - - ranking = 2.2keywords = meningitis (Clic here for more details about this article) |
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