Listeria monocytogenes meningitis

Area of Science:

• Infectious Diseases
• Neurology
• Clinical Microbiology

Background:

• Listeria meningitis is a serious infection, particularly in immunocompromised individuals.
• Understanding its clinical presentation and diagnostic challenges is crucial for timely treatment.

Purpose of the Study:

• To review the clinical history and findings of patients with Listeria meningitis.
• To identify predisposing factors and diagnostic patterns associated with Listeria meningitis.

Main Methods:

• Retrospective review of 23 patients with Listeria meningitis admitted to the University Hospital of Leuven (1967-1987).
• Exclusion of cases related to pregnancy or perinatal periods.
• Analysis of patient history, predisposing conditions, clinical presentation, and laboratory findings (CSF and blood cultures).

Main Results:

• Predisposing factors included renal transplants, immunosuppressive therapy, lymphoreticular diseases, and alcoholism.
• No specific clinical features distinguish Listeria meningitis from other bacterial meningitides.
• Cerebrospinal fluid (CSF) leukocyte counts varied widely, often with mononuclear predominance; glucose levels were not consistently decreased.
• Initial Gram stains were frequently unrevealing, with CSF cultures taking up to 4 days to yield positive results.
• Blood cultures were often critical for identifying Listeria.

Conclusions:

• Listeria meningitis presents with diverse clinical and CSF findings, lacking pathognomonic signs.
• Diagnostic delays are common due to non-specific symptoms and initial negative CSF tests.
• Blood cultures are essential for early and accurate diagnosis of Listeria meningitis.