[A case of Listeria meningitis associated with systemic lupus erythematosus]

We report a case of Listeria meningitis associated with systemic lupus erythematosus (SLE). The case is a 29-year-old female who was diagnosed as SLE on August, 1982, and had been followed since then. On May 25, 1993, she was admitted to our hospital with complaints of fever, head ache and vomiting which developed 3 days before admission. An examination of the cerebro-spinal fluid (CSF) revealed a cell count of (3664/3/mm3), protein concentration (123 mg/dl), and the quotient of CSF (Q albumin) (27.5) were elevated. A diagnosis of meningitis was made and therapy of antibiotics was begun. A CSF culture on admission was positive for Listeria monocytogenes, but the blood culture was negative. Clinical symptoms disappeared in about a week and abnormal CSF findings returned to normal in about a month with the administration of antibiotics. Listeria infection is a rare disease, but sometimes develops as an opportunistic infection in immunocompromised hosts. As far as we know, only 13 cases have been reported so far (9 cases in foreign countries, 4 cases in Japan). We also discuss Listeria infections associsted with SLE referring to the former reports.