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Listeria monocytogenes Infection of the Brain
05:02

Listeria monocytogenes Infection of the Brain

Published on: October 2, 2018

Community-acquired Listeria monocytogenes meningitis in adults

Matthijs C Brouwer1, Diederik van de Beek, Sebastiaan G B Heckenberg

  • 1Department of Neurology, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.c.brouwer@amc.uva.nl

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 20, 2006
PubMed
Abstract

Insights

Listeria monocytogenes meningitis, a common cause of bacterial meningitis, often presents without classic symptoms or typical cerebrospinal fluid findings. Many patients receive inadequate initial antimicrobial therapy, impacting outcomes.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Listeria monocytogenes is a significant cause of bacterial meningitis, particularly in immunocompromised individuals and the elderly.
  • Understanding the clinical presentation and management of Listeria monocytogenes meningitis is crucial for improving patient outcomes.

Purpose of the Study:

  • To prospectively evaluate clinical features, diagnostic findings, and treatment outcomes of community-acquired Listeria monocytogenes meningitis.
  • To assess the adequacy of initial antimicrobial therapy and its relation to patient outcomes.

Main Methods:

  • A nationwide prospective study in The Netherlands involving 30 episodes of Listeria monocytogenes meningitis.
  • Patients' clinical data, cerebrospinal fluid analysis, and initial antimicrobial regimens were analyzed.
  • Patient outcomes were assessed using the Glasgow outcome score.

Main Results:

  • Listeria monocytogenes meningitis occurred in immunocompromised or elderly patients (>50 years old).
  • Classic meningitis symptoms were infrequent (43%), and typical cerebrospinal fluid findings were absent in 23% of cases.
  • 17% mortality and 27% unfavorable outcomes were observed; inadequate initial antimicrobial therapy did not correlate with outcomes.

Conclusions:

  • Listeria monocytogenes meningitis may not present with typical clinical or cerebrospinal fluid findings, challenging early diagnosis.
  • A substantial proportion of patients received initial antimicrobial therapy lacking coverage for Listeria monocytogenes.
  • Despite inadequate initial therapy not being linked to outcomes in this study, appropriate antimicrobial selection remains critical.

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