Sepsis and Meningitis due to Listeria Monocytogenes

Abstract

PurposeThis study focused on the effect of immuno-compromising conditions on the clinical presentation of severe listerial infection.Patients and MethodsNine human listeriosis cases seen from 1991-2002 were reviewed. All adult patients, from whose blood, peritoneal fluid or cerebrospinal fluid (CSF) the L. monocytogenes was isolated, were included in this retrospective study.ResultsListeriosis presented as primary sepsis with positive blood cultures in 5 cases and meningitis with positive CSF cultures in 4 cases. All of these patients had at least one underlying disease, most commonly, hematologic malignancy, diabetes mellitus, amyloidosis and hepatic cirrhosis; 55.6% had received immunosuppressive or corticosteroid therapy within a week before the onset of listeriosis. The patients were adults with a mean age of 60 years. Fever, night sweats, chills and lethargy were the most common symptoms; high temperature (> 38℃), tachycardia, meningeal signs and poor conditions in general were the most common findings on admission. The mortality rate was 33.3% and was strictly associated with the severity of the underlying disease. Mortality differences were significant between sepsis (20%) and meningitis (50%) patients.ConclusionListeriosis as an uncommon infection in our region and that immuno-suppressive therapy is an important pre-disposing factor of listeriosis. Sepsis and meningitis were more common in this group of patients and had the highest case-fatality rate for food-borne illnesses.

Bacterial Meningitis in Patients using Immunosuppressive Medication: a Population-based Prospective Nationwide Study

“…Adjunctive dexamethasone is widely prescribed for patients using immunosuppressive medication who are admitted with bacterial meningitis and is not associated with harm. The association of Listeria infections with immunosuppressive medication, and glucocorticoids especially, has been well recognized by earlier studies (Hooper et al 1982;Yildiz et al 2007). The predilection for immunocompromised hosts may be explained by the intracellular life cycle of L. monocytogenes by which it avoids host bactericidal mechanisms.…”

“…A meta-analysis showed an increased risk of systemic infections for patients using corticosteroids compared to patients not using corticosteroids, with a relative risk of 1.6 (95 % confidence interval [CI] 1.3-1.9), although it remains unclear whether corticosteroids or the underlying disease increased the risk of infection (Stuck et al 1989). The use of immunosuppressive medication has been reported to be an important predisposing factor for infections with Listeria monocytogenes (Yildiz et al 2007). Glucocorticoids can also mask the symptoms of infection and therefore delay treatment because patients present at an advanced stage of disease (Fardet et al 2007).…”

Genes Associated with Desiccation and Osmotic Stress in Listeria monocytogenes as Revealed by Insertional Mutagenesis

“…L. monocytogenes is ubiquitous in nature but is transmitted to humans predominantly through contaminated food, with the majority of listeriosis outbreaks being associated with ready-to-eat (RTE) products, such as deli meats, soft cheeses, and fresh produce (1,2). Listeriosis is a very serious disease with mortality rates of 20 to 40% (3). Populations which are more susceptible to listeriosis include the elderly, pregnant women, newborns, and immunocompromised individuals.…”

Listeria septicemia accompanied by central nervous system involvement in a patient with multiple myeloma and secondary diabetes

“…Listeria monocytogenes causes life-threatening infections with high mortality, especially in neonates, pregnant women, the elderly, and immunosuppressed patients [5–7]. Meningitis is usually seen in immunosuppressed people [8]. …”