ВведениеВезикулёзный риккетсиоз (ВР) -описанное в середине ХХ в. заболевание из группы клещевых пятнистых лихорадок, передаваемое человеку гамазовыми клещами. С 1946 по 1952 г. американски-ми исследователями в г. Нью-Йорке и на Атлантическом побережье Северной Америки (от Филадельфии до Бостона) описано свыше 1000 случаев риккетсиозной оспы, изучены этиология и эпидемиология заболевания [1-3].

Nervous forms of listeriosis are observed in 5%10% of persons suffering from this disease and in 75% of children with bacteriologically confirmed listeriosis as well. The most widespread clinical variant is Listeria meningitis, making up 15% of all cases of bacterial and serous meningitides. The mortality rate at neurolisteriosis reaches 30%40%. A case of acute meningoencephalitis associated with Listeria monocytogenes 4b in a 37-year-old immunocompetent woman is described. The disease was characterized by subacute onset, manifested intoxication, long-lasting and high-grade fever, cerebral coma, bulbar syndrome, right-side hemiparesis, bilateral hypertonus of the wrist flexors, strabism, anisocoria, manifested leukocytosis with leukocyte formula stab shift, ESR 4559 mm/hour. Cerebrospinal fluid test: cytosis 663 сells in 1 mcl, neutrophils 79%, lymphocytes 21%, protein 1451 mg/l, glucose 3.8 mmol/l. Diagnosis had been confirmed with detection of IgM against Listeria monocytogenes 4b in liquor using the indirect immunofluorescence reaction and Listeria monocytogenes by means of PCR. Antibacterial therapy had been conducted using Meropenem, Ampicillinum, endolumbal administration of 4 mg once daily of Gentamycinum combined with intravenous administration of 24 million of units/day of Penicillin. On day 50, she was transferred for rehabilitation treatment to the Department of Neurology.