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[Meningitis from Listeria monocytogenes in the adult]
F Laguna1, E Valencia, A Enríquez
1Servicio de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid.
Abstract:
We describe the characteristics of 6 adult patients with meningitis by Listeria monocytogenes. Five of them had previous disease and only one of these was being treated with immunosuppressors. All of them presented meningeal syndrome with cephalorhachidean fluid's pleocytosis and five of them, polymorphonuclear predominance. The empirical treatment was correct only in two cases. The mortality rate reached 50%.
Insights
Listeria monocytogenes meningitis is a severe infection, particularly in adults with prior illness. High mortality rates underscore challenges in empirical treatment and patient outcomes.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Context:
- Listeria monocytogenes is an opportunistic pathogen causing meningitis, especially in vulnerable populations.
- Adult meningitis cases present diagnostic and therapeutic challenges.
- Understanding risk factors and clinical features is crucial for effective management.
Purpose:
- To characterize the clinical presentation and outcomes of adult patients with Listeria monocytogenes meningitis.
- To evaluate the appropriateness of empirical treatment strategies.
- To identify factors influencing mortality in this patient group.
Summary:
- This study details 6 adult cases of Listeria monocytogenes meningitis.
- Five patients had a history of previous disease, with one on immunosuppressants.
- Clinical findings included meningeal syndrome, pleocytosis, and frequent polymorphonuclear predominance in cerebrospinal fluid.
- Appropriate empirical treatment was administered in only two cases.
- The observed mortality rate was 50%.
Impact:
- Highlights the severity and high mortality associated with Listeria monocytogenes meningitis in adults.
- Suggests a need for improved diagnostic accuracy and timely, targeted antimicrobial therapy.
- Informs clinical practice regarding the management of suspected bacterial meningitis, particularly in immunocompromised or previously ill individuals.