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A 48-year-old man with fever, nauseous, vomiting, and dizzy: A CARE case report
1Department of Thoracic Surgery, Shangluo Central Hospital, Shangluo, China.
Rationale:
Listeria monocytogenes (LM) is an important foodborne bacterium, and LM meningoencephalitis is rare in clinical practice, with poor prognosis in severe patients. It is prone to misdiagnosis in clinical practice. We first reported a case of severe LM meningoencephalitis with muscle lesions and evaluated the comprehensive condition.
Patient Concerns:
A 48-year-old man had a fever and was admitted to the neurology department due to dizziness, nausea, and vomiting for 20 days.
Diagnoses:
LM meningoencephalitis complicated with muscle lesions.
Interventions:
We used moxifloxacin 0.4 g, qd, meropenem 2 g, q8h, and dexamethasone 10 mg, qd to reduce exudation and adhesion. Then due to consideration of side effects, we increased the dose of ampicillin by 2 g, q4h, stopped using meropenem and moxifloxacin, and turned to maintenance treatment with dexamethasone and ampicillin. We comprehensively managed his vital signs and physical organ functions, we also controlled some comorbidities. During the hospitalization period thereafter, we used intravenous anti-infection treatment with moxifloxacin 0.4 g, qd, ampicillin 0.5 g, q4h.
Outcomes:
Half a year later, the reexamination showed only protein elevation in cerebrospinal fluid and hydrocephalus in MRI. Afterward, the symptoms did not recur again. The patient recovered well after discharge.
Lessons:
LM meningoencephalitis complicated with lower limb muscle lesions is clinically rare. This report focuses on relevant treatment plans, which provide value for the examination and comprehensive management of patients with LM infection in the future.
Insights
This case report details a rare instance of severe Listeria monocytogenes (LM) meningoencephalitis with muscle lesions. Prompt diagnosis and comprehensive treatment led to the patient's successful recovery and symptom resolution.
Area of Science:
- Neurology
- Infectious Diseases
- Bacteriology
Background:
- Listeria monocytogenes (LM) is a significant foodborne pathogen.
- LM meningoencephalitis is a rare but severe condition with a poor prognosis, often leading to misdiagnosis.
- This report presents a unique case of severe LM meningoencephalitis complicated by muscle lesions.
Purpose of the Study:
- To report a rare case of severe Listeria monocytogenes meningoencephalitis with associated muscle lesions.
- To evaluate the comprehensive management and treatment strategies for this complex clinical presentation.
- To provide insights for future diagnosis and management of LM infections.
Main Methods:
- A 48-year-old male patient presented with fever and neurological symptoms including dizziness, nausea, and vomiting.
- Treatment involved a combination of moxifloxacin, meropenem, and dexamethasone, followed by adjustments including ampicillin.
- Comprehensive management of vital signs, organ functions, and comorbidities was undertaken.
Main Results:
- The patient experienced significant improvement following the therapeutic interventions.
- Follow-up examinations revealed only mild cerebrospinal fluid protein elevation and hydrocephalus on MRI.
- The patient demonstrated a good recovery with no recurrence of symptoms after discharge.
Conclusions:
- LM meningoencephalitis with lower limb muscle lesions represents a clinically rare entity.
- The presented case and treatment plan offer valuable information for the examination and comprehensive management of patients with LM infections.
- This highlights the importance of considering LM in neurological presentations, especially with unusual complications.
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