Clinical Presentation and Outcome of Listeriosis in Patients with and without Immunosuppressive Therapy

Abstract

Seventy-four cases of systemic listeriosis occurring from 1971 to 1989 in the greater Helsinki area in Finland are reviewed with a special interest in the effect of preceding immunosuppressive therapy on the clinical presentation. Of these patients, 66% had an underlying disease, most commonly malignancy, diabetes mellitus, or renal transplantation, and 43% had received immunosuppressive therapy within 1 week before onset of listeriosis. Bacteremia and central nervous system infections (both in 43% of cases) were the most common clinical entities. The percentage of patients with meningitis was not greater among immunosuppressed patients (13/32, 41%) than among patients with underlying diseases not treated with immunosuppressive agents (9/16, 56%) or among previously healthy nonpregnant hosts (7/11, 64%). Immunosuppressed patients did not die more frequently than did those with underlying diseases not treated with immunosuppressive therapy (case fatality rate, 29% vs. 38%, respectively). However, all previously healthy non-neonatal patients survived, whereas 32% (15/47) of those with any kind of underlying disease succumbed.

Sorovares de Listeria monocytogenes e espécies relacionadas, isoladas de material clínico humano

“…Curiosamente, raras são as citações na literatura sobre a presença da última espécie em material clínico humano 23 28 e a veiculação dessas espécies não patogênicas certamente, se faz através dos alimentos, considerando que a L. innocua sorovar 6a predominou nos produtos de laticínios e cárneos (processados e não processados) superando L. monocytogenes sorovar 1 / 2 a em derivados do leite e 4b e 1 / 2 b em carnes e embutidos 10 . Diante da situação retratada, corrobora-se com a hipótese da infecção endógena, isto é, resultante da ingestão de alimentos contaminados e da colonização da bactéria no trato entérico, particularmente em pacientes sob a intervenção de fármacos imunossupressores, que além de diminuir a resistência do indivíduo à infecção, danificam também a mucosa 34 .…”

Listeriosis Due to Infection with a Catalase-Negative Strain of Listeria monocytogenes

“…Serotypes 1/2 and 4 are the most commonly reported (1) and may cause meningitis in immunocompromised patients or patients receiving immunosuppressive therapy (11). Identification of L. monocytogenes relies on a number of phenotypic criteria, including Gram stain appearance, colonial morphology, hemolysis, tumbling motility, and a number of biochemical reactions.…”

Listeriosis – a dangerous, contagious disease. Meningitis caused by Listeria monocytogenes – case report

“…Pierwsza z nich to tzw. zapalenie podostre, objawiające się wcześnie -po kilku dniach od zakażenia -podwyższoną temperaturą ciała, bóla-mi głowy i sztywnością karku [10]. Druga, cięższa postać choroby, przebiega jako zapalenie tyłomózgo-wia z bólem głowy, nudnościami i wymiotami, a także występującą u większości chorych podwyższoną tem-peraturą ciała.…”