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Oral Transmission of Listeria monocytogenes in Mice via Ingestion of Contaminated Food
Published on: May 6, 2013
Listeria monocytogenes meningitis in adults. Sixteen consecutive cases 1973-1982
Abstract:
16 adult patients with Listeria monocytogenes meningitis were reviewed to see whether clinical features or initial laboratory findings could discriminate between these patients and patients with purulent meningitis of other causes. Six patients suffered from known predisposing diseases and 4 were alcoholics. The initial clinical picture was indistinguishable from meningitis of other causes. Microscopy of cerebrospinal fluid (CSF) was negative in all cases but 2 where gram-positive rods were seen. CSF cytology and biochemistry could not discriminate from other causes of purulent meningitis although a low leucocyte content and a low percentage of neutrophils were often present. All L. monocytogenes strains isolated were sensitive to ampicillin and aminoglycosides whereas susceptibility to other antibiotics was low or varying. In adult patients suffering from purulent meningitis initial therapy should include ampicillin until an etiological diagnosis is established. The same is true in some cases of febrile encephalopathy with low content of neutrophils in CSF, especially when the glucose content is low.
Insights
Clinical features and initial lab results in adult Listeria monocytogenes meningitis are often indistinguishable from other causes. Early ampicillin treatment is recommended for suspected bacterial meningitis in adults.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Listeria monocytogenes meningitis is a severe infection, particularly in adults.
- Distinguishing Listeria meningitis from other bacterial meningitis forms based on initial presentation is challenging.
Purpose of the Study:
- To determine if clinical features or initial laboratory findings can differentiate Listeria monocytogenes meningitis from other causes of purulent meningitis in adults.
- To assess the antibiotic susceptibility of isolated L. monocytogenes strains.
Main Methods:
- Retrospective review of 16 adult patients with confirmed Listeria monocytogenes meningitis.
- Analysis of clinical presentations, cerebrospinal fluid (CSF) microscopy, cytology, and biochemistry.
- Evaluation of antibiotic susceptibility patterns for isolated L. monocytogenes strains.
Main Results:
- Initial clinical presentation and CSF analysis (microscopy, cytology, biochemistry) were largely non-specific and could not reliably distinguish Listeria meningitis from other purulent meningitis.
- Low leukocyte count and neutrophil percentage in CSF were noted in some Listeria cases.
- All isolated L. monocytogenes strains were susceptible to ampicillin and aminoglycosides.
Conclusions:
- Clinical and initial laboratory findings are insufficient to differentiate Listeria monocytogenes meningitis from other causes of purulent meningitis in adults.
- Empirical treatment with ampicillin is crucial for suspected bacterial meningitis in adults until an etiological diagnosis is confirmed.
- Ampicillin is also recommended for febrile encephalopathy with specific CSF profiles (low neutrophils, low glucose).
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