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Listeria cerebritis: relapse of infection in renal transplant patients

G W Watson, T J Fuller, J Elms

    Archives of Internal Medicine
    |January 1, 1978
    PubMed

    Insights

    Listeria cerebritis relapsed in two patients despite initial antimicrobial treatment. Extended penicillin therapy for six weeks led to significant clinical improvement, suggesting longer treatment durations are crucial for these infections.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Microbiology

    Background:

    • Listeria infections, including septicemia and meningitis, can occur in immunocompromised individuals.
    • Cerebritis, an inflammation of the brain, is a serious complication of Listeria infections.

    Observation:

    • Two of three patients with Listeria cerebritis experienced relapse after 10-14 days of intravenous penicillin therapy.
    • Relapse presented with fever and acute focal cerebral dysfunction, while initial diagnostic tests were inconclusive.

    Findings:

    • Extended six-week penicillin treatment resulted in rapid clinical responses for patients with relapsed Listeria cerebritis.
    • Brain imaging normalized after the prolonged treatment course, indicating resolution of the cerebritis.

    Implications:

    • A high relapse rate (35%) is noted in transplant patients with Listeria meningitis/bacteremia treated for less than three weeks.
    • This study highlights the potential for cerebritis relapse and recommends high-dose penicillin or ampicillin therapy for four to six weeks for Listeria infections in select patient groups.

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