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Listeria monocytogenes Infection of the Brain
05:02

Listeria monocytogenes Infection of the Brain

Published on: October 2, 2018

Fatal meningitis due to Listeria monocytogenes in elderly patients with underlying malignancy

S Levidiotou1, K Charalabopoulos, G Vrioni

  • 1Department of Microbiology, Medical School, University of Ioannina, Ioannina, Greece.

International Journal of Clinical Practice
|May 1, 2004
PubMed

Insights

Adult cancer patients face high risk of Listeria monocytogenes meningitis. Early suspicion and empirical treatment covering Listeria are crucial due to high mortality in this immunosuppressed group.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Oncology

Background:

  • Adult patients with malignancies are recognized as a high-risk group for invasive bacterial infections, including meningitis.
  • Listeria monocytogenes meningitis poses a significant threat to immunocompromised individuals, particularly those undergoing cancer therapy.

Observation:

  • A retrospective review of the University Hospital of Ioannina's Microbiology Laboratory database (1990-2002) identified three cases of Listeria monocytogenes meningitis.
  • All three patients were elderly (over 70) with active malignancies (brain tumor, chronic lymphocytic leukemia, non-Hodgkin's lymphoma) and were receiving treatment.
  • Listeria monocytogenes type 4b was isolated from blood and cerebrospinal fluid in all cases.

Findings:

  • Despite treatment with ampicillin and gentamicin, all three patients experienced a fatal outcome shortly after treatment initiation.
  • These cases highlight the extremely high mortality rate associated with Listeria monocytogenes meningitis in immunosuppressed cancer patients.

Implications:

  • Listeriosis should be strongly suspected in patients presenting with meningitis and a history of malignancy.
  • Given the clinical indistinguishability from other bacterial meningitis types, empirical antibiotic therapy for bacterial meningitis in immunosuppressed patients should include coverage for Listeria monocytogenes.

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