Listeria monocytogenes meningitis in adults. Sixteen consecutive cases 1973-1982

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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