Clinical characteristics and antiinfective treatment in Listeria monocytogenes meningitis

Abstract:

ObjectiveTo describe clinical characteristics and antiinfective treatment of Listeria monocytogenes (L. monocytogenes) meningitis. MethodsClinical manifestations and cerebrospinal fluid (CSF) examination results of 6 patients with L. monocytogenes meningitis in a hospital were analyzed retrospectively. Evaluation methods were developed according to relevant guidelines and literatures, antiinfective treatment and prognosis of patients with L. monocytogenes meningitis were evaluated. ResultsTwo of 4 adults with L. monocytogenes meningitis had triad of fever, stiff neck, and altered mental status, the mean white blood cell count (WBC) of the initial CSF detection was 997×106/L, CSF/blood glucose ratio was 0.32, CSF protein was 1.43g/L; the other 2 neonates had fever, epilepsy, and hyponatremia, WBC were both>1 000×106/ L，CSF protein were both＞1 g/L, CSF/blood glucose ratio was＜0.5. Of 6 patients, none were treated with appropriate initial empiric antiinfection therapy, confirmed by CSF or blood culture, 5 cases were treated with ampicillin antiinfective therapy, 1 used compound sulfamethoxazole due to penicillin allergy; 1 neonate died, 1 elderly patient was with moderate disability, the remaining 4 cases were all recovered and discharged from hospital. ConclusionClinical manifestations and CSF findings of L. monocytogenes meningitis are not different from other purulent meningitis, commonly used antimicrobial agents for the treatment of purulent meningitis are not sensitive to L. monocytogenes, which should be paid attention in clinic.