Listerial Meningitis and Brain Abscess With Coexisting COVID-19 Infection in a Young, Immunocompetent Male: A Case Report

Abstract

Listeria monocytogenes (LM) is a gram-positive intracellular pathogen that can cause central nervous system infections such as meningitis, meningoencephalitis, rhombencephalitis, or cerebritis. It rarely causes a brain abscess. Listerial meningitis and brain abscess most commonly occur in immunocompromised individuals, neonates, pregnant females, alcoholics, and the elderly. We present a unique case of a young immunocompetent male who presented with listerial meningitis and brain abscess. Coexisting coronavirus disease 2019 (COVID-19) infection was also present. Since LM was not included in the differentials, the standard antibiotic regimen started for the meningitis therapy was ineffective. Remdesivir was administered to treat the coexisting COVID-19 infection. When the lumbar tap polymerase chain reaction pointed out that the causative agent was Listeria, we shifted to ampicillin and gentamicin therapy, to which the patient responded very effectively. LM is an atypical cause of meningitis and brain abscesses. A high index of suspicion is therefore required for early detection and effective treatment of listerial meningitis and brain abscess.

Listeria monocytogenes bacteremia developed during treatment of COVID‐19

“…To our knowledge, this is the first case of L. monocytogenes bacteremia co‐occurring with COVID‐19 in Japan, similar to that reported from Pakistan 6 . Russell et al.…”

“…To our knowledge, this is the first case of L. monocytogenes bacteremia co-occurring with COVID-19 in Japan, similar to that reported from Pakistan. 6 Russell et al reported that bloodstream infections were most frequently caused by Escherichia coli and Staphylococcus aureus in immunocompromised COVID-19 patients, but no case with listeria bacteremia was identified from their multicenter cohort study. 5 L. monocytogenes is an important bacterium in older people and immunosuppressed patients as it can sometimes lead to serious conditions.…”

“… 4 However, multicenter study from the United Kingdom which enrolled total number of 48,902 COVID‐19 patients had no case of Listeriosis and we found only once case of co‐infected with Listeriosis from Pakistan. 5 , 6 We report a case of L. monocytogenes bacteremia that developed during treatment for COVID‐19.…”

Molecular characterization of head and neck infection causing bacterial communities using 16S rRNA in eastern Indian population

“…Although HNIs are prevented by the widespread use of antibiotics for the initial infections, it is still a serious illness that deteriorates over time, especially when it descends into the mediastinum. The mortality rate in this case is 10-40% due to sepsis and organ failure [8,9]. Bacterial colonization within the brain results in a brain abscess which leads to serious consequences.…”

An unusual presentation of fungal brain abscess in immunocompetent host

“…Focal area of necrosis, with a surrounding membrane within the brain parenchyma, usually resulting from an infectious process or rarely from a traumatic process, known as brain abscess. 1 It may be originated from infections in surrounding area of head and neck or spread from distant organs as hematogenous seedling, known as primary brain abscess. Those that occur after brain injury or brain surgery, these abscesses are labelled secondary brain abscess.…”