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Listerial meningitis. Which patients are vulnerable?
1Overlook Hospital, Summit, New Jersey.
Abstract:
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.
Insights
Elevate suspicion for Listeria monocytogenes infection in meningitis patients with compromised immunity. Diagnosis requires cerebrospinal fluid organism isolation, though treatment typically leads to recovery.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Listeria monocytogenes is an opportunistic pathogen.
- Meningitis can be caused by various pathogens, including bacteria.
- Impaired cell-mediated immunity increases susceptibility to infections.
Observation:
- Patients presenting with meningitis and impaired cell-mediated immunity warrant a high index of suspicion for Listeria monocytogenes.
- Cerebrospinal fluid (CSF) analysis may show elevated white blood cell count and protein levels.
- Definitive diagnosis relies on the isolation of Listeria monocytogenes from CSF.
Findings:
- Isolation of Listeria monocytogenes from CSF is the gold standard for diagnosis.
- Prompt and appropriate antibiotic therapy is crucial for patient outcomes.
- Most patients recover with timely and effective treatment.
Implications:
- Clinicians should consider Listeria monocytogenes in meningitis cases with immune compromise.
- Early diagnostic efforts focusing on CSF culture are vital.
- Effective antibiotic regimens can prevent severe complications and mortality associated with Listeria meningitis.