Detection of Listeria monocytogenes in a patient with meningoencephalitis using next-generation sequencing: a case report

Abstract

Background Listeria monocytogenes (L. monocytogenes) is a facultative intracellular bacterial pathogen which can invade different mammalian cells and reach to the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), the traditional test often reports negative owing to the antibiotic treatment or a low number of bacteria in the cerebrospinal fluid. To date, timely diagnosis and accurate treatment remains a challenge for patients with listeria infections. Case presentation We present the case of a 66-year-old woman whose clinical manifestations were suspected as tuberculous meningoencephalitis, but the case was finally properly diagnosed as LMM by next-generation sequencing (NGS). The patient was successfully treated using a combined antibacterial therapy, comprising ampicillin and trimethoprim-sulfamethoxazole. Conclusion To improve the sensitivity of LMM diagnosis, we used NGS for the detection of L. monocytogenes. Hence, the clinical utility of this approach can be very helpful since it provides quickly and trust results.

A Retrospective Study of Rare Listeria Meningoencephalitis in Immunocompetent Children in China

“…Prehospital antibiotic use may induce atypical CSF alterations. Monocyte predominance can make the early diagnosis of LMM in patients challenging and occasionally the disease is misdiagnosed as tuberculous meningitis ( 20 ) which is a relatively common disease in northwestern China.…”

“…mNGS can detect all nucleic acids in a specimen containing the host and microbial sequences by sequencing the total DNA or RNA to identify pathogens. This approach overcomes the limitations of traditional pathogen detection with expanded coverage and improved sensitivity and is less affected by previous antimicrobial exposure and the length of the course of treatment ( 20 ). The properties support the use of mNGS delivery in rapid diagnosis.…”

“…Carbapenems used alone or in combination with aminoglycoside have also shown good results ( 12 , 13 ). Trimethoprim-sulfamethoxazole (TMP/SMX) was recently described as an effective alternative in CNS listeriosis ( 13 , 16 , 20 ). Aminoglycosides are limited in pediatric cases due to toxicity.…”

Diagnosis of Enterococcus faecalis meningitis associated with long-term cerebrospinal fluid rhinorrhoea using metagenomics next-generation sequencing: a case report

“…In addition, mNGS is appropriate for various specimen types, including peripheral blood, CSF, tissue, sputum, and bronchoalveolar lavage [ 11 ]. Many reports [ 12 – 16 ] show the strong potential of mNGS in infectious disease diagnostics compared with traditional methods.…”

Multiple brain abscesses due to Listeria monocytogenes infection in a patient with systemic lupus erythematosus: A case report and literature review

“…To improve prognosis, early diagnosis is crucial, followed by timely treatment. 41 Early empirical therapy is essential for favorable outcomes of Listeria infection. 42 A retrospective case-control study indicated that delaying appropriate antibiotic therapy for more than 6 hours increased the risk of mortality by 2.78-fold.…”