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Listeria Meningitis

Listeria Meningitides


Presentation

  • The patients were aged 53, 51 and 56 years and presented 4, 7 and 90 months post-transplant, respectively.[ncbi.nlm.nih.gov]
  • We present these cases because Listeria infection, although common in neonates, is extremely infrequent during infancy and childhood.[ncbi.nlm.nih.gov]
  • A case report of a listeria meningitis 5 days after diagnosis of meningococcal meningitis in a immunocompetent child of 2 years is presented. The infection occurred during hospital admission.[ncbi.nlm.nih.gov]
  • We present, to the best of our knowledge, the first case of listeria meningitis with increased adenosine deaminase (ADA) in cerebrospinal fluid.[ncbi.nlm.nih.gov]
  • We present the case of a previously healthy 2-year-old boy diagnosed with listeria meningitis.[ncbi.nlm.nih.gov]
Fever
  • Abstract A 65-year-old man with primary haemochromatosis was admitted because of fever and confusion. He was found to have bacteraemia and meningitis due to Listeria monocytogenes.[ncbi.nlm.nih.gov]
  • A 90-year-old woman presented with high fever, nausea, diarrhea, and incontinence of urination and feces. Lumbar puncture was performed.[ncbi.nlm.nih.gov]
  • Intravenous ampicillin improved the symptoms of fever, bloody diarrhea, and headache without any neurological sequelae.[jstage.jst.go.jp]
  • The main symptoms were a fever, chills, night sweats and meningeal signs.[ncbi.nlm.nih.gov]
  • Clinical manifestations include FEVER, altered mentation, HEADACHE, meningeal signs, focal neurologic signs, and SEIZURES. (From Medicine 1998 Sep;77(5):313-36) [ ] Synonyms: Meningitis, Listeria[ebi.ac.uk]
Chills
  • The patient had followed Department of Health advice to immunocompromised patients and had avoided soft cheeses, cook-chill meals, and salads. He had, however, recently eaten paté produced in Belgium.[ncbi.nlm.nih.gov]
  • Symptoms caused by this organism can be similar to flu and include high temperature, muscle ache or pain, chills, feeling or being sick and diarrhoea.[metro.co.uk]
  • Tests uncovered Listeria monocytogenes, which can cause high temperature, muscle ache or pain, chills, feeling or being sick and diarrhoea. However, in rare cases, the infection can be more severe, causing serious complications, such as meningitis .[mirror.co.uk]
  • The main symptoms were a fever, chills, night sweats and meningeal signs.[ncbi.nlm.nih.gov]
  • Chill : Make sure that your fridge is at 5 C or below. Put chilled food in the fridge straight away and eat it as soon as possible. Throw out food that has passed the ‘use by’ or the ‘best before’ date.[safefood.eu]
Malaise
  • She had been unwell with fever and malaise for 3 days. On examination, her temperature was 39.1 C, pulse rate was 90 per minute and blood pressure 150/90 mm Hg. She was alert with no signs of meningism.[pn.bmj.com]
  • Fever and malaise Clinical features during admission Embolism No Yes No No Heart failure Yes Yes No No Kidney failure Yes No No No Persistent infection b No No No No Septic shock No No No No Vegetation diameter, mm 4,7 7 12 5,4 Periannular complication[revespcardiol.org]
  • […] renal failure) immunosuppression (e.g. functional asplenia, splenectomy, hypogammaglobulinemia, complement deficiency, steroids, diabetes mellitus) malnutrition low socioeconomic status and overcrowding exposure to epidemic CLINICAL FEATURES History malaise[lifeinthefastlane.com]
  • On day 12, he developed a fever, night sweats, chills, dyspnea and general malaise.[ncbi.nlm.nih.gov]
Rigor
  • Journal of Probiotics & Health is one of the top leading journals in biomedical engineering which publishes novel research articles after rigorous peer-review process by at least 2 expert reviewers of the associated fields.[omicsonline.org]
  • Listeria Meningitis in a Pregnant Woman with Ulcerative Colitis Receiving Infliximab" OMICS Group is one of the top open access publishers with 700 peer-reviewed journals along with eminent scientists in its Editorial Board and expert reviewers to carry rigorous[omicsonline.org]
  • The fever was intermittent, high grade, not associated with chills and rigors, was occurring daily and used to normalize with antipyretic medications. The headache was continuous, holocranial, throbbing and was associated with nausea and vomiting.[neurologyindia.com]
High Fever
  • A 90-year-old woman presented with high fever, nausea, diarrhea, and incontinence of urination and feces. Lumbar puncture was performed.[ncbi.nlm.nih.gov]
  • On physical examination, he had lethargy and acutely ill with a high fever (temperature 38 ), tachycardia and meningeal signs.[ncbi.nlm.nih.gov]
  • However, the high fever persisted and his clinical condition deteriorated.[scielo.br]
  • Read more: Meningitis » The hallmark symptoms of bacterial meningitis are: high fever stiff neck severe headache If you develop the disease, you may also experience: nausea vomiting sensitivity to bright light confusion a rash of purple discoloration[healthline.com]
Severe Clinical Course
  • Despite of our patient had no such data, the disease had severe clinical course with the both of purulent meningoencephalitis and sepsis.[aclr.com.es]
Vomiting
  • A two month old male child was admitted to the hospital with a history of fever, vomiting and loose motions for 2-3 days. The patient also had convulsions twice before admission.[jpgmonline.com]
  • The signs and symptoms include fever, headache, vomiting, diarrhea and altered mental status [ 1 – 16 ], as also seen in our case.[ijponline.biomedcentral.com]
  • Call your doctor immediately if your child develops fast or labored breathing, a fever, loss of appetite, vomiting, dehydration , a high-pitched cry, excessive sleepiness, or irritability.[kidshealth.org]
  • Call your doctor immediately if your child develops fast or labored breathing, a fever, loss of appetite, vomiting, dehydration, a high-pitched cry, excessive sleepiness, or irritability.[kidshealth.org]
  • He had suffered fever (up to 39.2ºC), headache, nausea, and vomiting for three days prior to admission. He had no history of recent travel and sick contacts. His past medical history was non-significant.[scielo.br]
Nausea
  • A 90-year-old woman presented with high fever, nausea, diarrhea, and incontinence of urination and feces. Lumbar puncture was performed.[ncbi.nlm.nih.gov]
  • Other symptoms include high temperatures, muscle aches, chills, nausea and diarrhoea. The now-recalled sandwich meat has a use-by date of February 21. The FSA said: ‘If you have bought the above product, do not eat it.[metro.co.uk]
  • He had suffered fever (up to 39.2ºC), headache, nausea, and vomiting for three days prior to admission. He had no history of recent travel and sick contacts. His past medical history was non-significant.[scielo.br]
  • Primary clinical picture manifests as intestinal infection - diarrhea, nausea and vomiting [ 2 ].[aclr.com.es]
  • Encephalitis caused by Listeria are often misdiagnosed initially due a nonspecific prodromal (fever, headache, nausea and vomiting) and unusual meningeal signs 1-3 .[radiopaedia.org]
Tachycardia
  • On physical examination, he had lethargy and acutely ill with a high fever (temperature 38 ), tachycardia and meningeal signs.[ncbi.nlm.nih.gov]
Photophobia
  • There are often other symptoms, such as Nausea Vomiting Photophobia (increased sensitivity to light) Altered mental status (confusion) In newborns and babies, the meningitis symptoms of fever, headache, and neck stiffness may be absent or difficult to[cdc.gov]
Headache
  • Intravenous ampicillin improved the symptoms of fever, bloody diarrhea, and headache without any neurological sequelae.[jstage.jst.go.jp]
  • Clinical manifestations include FEVER, altered mentation, HEADACHE, meningeal signs, focal neurologic signs, and SEIZURES. (From Medicine 1998 Sep;77(5):313-36) [ ] Synonyms: Meningitis, Listeria[ebi.ac.uk]
  • We report a 60-year-old immunocompetent woman who presented with progressively intermittent headache for 3 weeks. Brain magnetic resonance imaging revealed leptomeningeal enhancement on T1-weighted imaging.[tzuchi.com.tw]
  • Eight days after the last alemtuzumab infusion, the patient developed headache and meningism.[neurology.org]
  • Symptoms of a Listeria infection can take up to 70 days to develop and include fever, headache, muscle aches, upset stomach, diarrhea, stiff neck, loss of balance, and confusion.[foodpoisoningbulletin.com]
Seizure
  • Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer.[books.google.ro]
  • Clinical manifestations include FEVER, altered mentation, HEADACHE, meningeal signs, focal neurologic signs, and SEIZURES. (From Medicine 1998 Sep;77(5):313-36) [ ] Synonyms: Meningitis, Listeria[ebi.ac.uk]
  • Patients with impairment of consciousness, neurological deficits, or seizures, underwent cranial computed tomography (CT) before lumbar puncture.[bmcinfectdis.biomedcentral.com]
  • Patients may present with seizures, cranial neuropathies, hemiplegia, and other evidence of focal disease, as well as with global cerebral dysfunction manifested as coma.[ahcmedia.com]
Neck Stiffness
  • After 5 days, he developed an impaired consciousness, headache, and neck stiffness. A sample of the colonic mucosa, blood cultures, and cerebrospinal fluid revealed Listeria monocytogenes infection.[jstage.jst.go.jp]
  • The prevalence of the classic triad of fever, neck stiffness, and altered mental status was 43%, and almost all patients presented with at least 2 of the 4 classic symptoms of headache, fever, neck stiffness, and altered mental status.[academic.oup.com]
Confusion
  • Abstract A 65-year-old man with primary haemochromatosis was admitted because of fever and confusion. He was found to have bacteraemia and meningitis due to Listeria monocytogenes.[ncbi.nlm.nih.gov]
  • Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer.[books.google.ro]
  • Symptoms of a Listeria infection can take up to 70 days to develop and include fever, headache, muscle aches, upset stomach, diarrhea, stiff neck, loss of balance, and confusion.[foodpoisoningbulletin.com]
  • While older children and adults typically present with fever, neck stiffness, headache, and confusion, initial symptoms in neonates are frequently nonspecific, including fever, irritability, excessive crying or sleepiness, and difficulty with feeding.[jcm.asm.org]
  • Read more: Meningitis » The hallmark symptoms of bacterial meningitis are: high fever stiff neck severe headache If you develop the disease, you may also experience: nausea vomiting sensitivity to bright light confusion a rash of purple discoloration[healthline.com]
Altered Mental Status
  • While the entire meningitis triad of nuchal rigidity, fever and altered mental status was present in only 43% of patients, 97% had at least 2 of 4 symptoms and/or signs if headache is added to the triad.[ahcmedia.com]
  • The prevalence of the classic triad of fever, neck stiffness, and altered mental status was 43%, and almost all patients presented with at least 2 of the 4 classic symptoms of headache, fever, neck stiffness, and altered mental status.[academic.oup.com]

Workup

Hyponatremia
Listeria Monocytogenes
  • Listeria monocytogenes grew in the culture of the pericardial fluid. Documentation of Listeria monocytogenes pericarditis is extremely rare, and data on the patient described and on seven published cases are reported.[ncbi.nlm.nih.gov]
  • We present a case of a previously healthy 7-year-old boy who developed Listeria monocytogenes meningitis.[ncbi.nlm.nih.gov]
  • Inflammatory lesions were associated with the presence of Listeria monocytogenes, as demonstrated by a positive anti-Listeria monocytogenes immunoperoxidase reaction within phagocytic cells.[visavet.es]
  • This reports an unusual case of central diabetes insipidus following SIADH secondary to listeria monocytogenes meningitis in a neonate.[ncbi.nlm.nih.gov]
  • Abstract We report two cases of meningitis caused by Listeria monocytogenes in children.[ncbi.nlm.nih.gov]
Gram-Positive Rods
  • Gram positive rod Beta hemolytic Catalase positive Motile at 25 degree centigrade (tumbling motility/umbrella motility) Non-spore forming rod Susceptible hosts Newborns Elderly Immunocompromised.[meddean.luc.edu]
  • An early presumptive diagnosis of Listeria infection may be possible with close attention to preliminary reports of Gram-positive rods.[neoreviews.aappublications.org]
  • On the 4th hospital day, the culture of CSF grew short Gram-positive rods later identified as serotype 4b of L. monocytogenes which was susceptible to ampicillin, amikacin, erythromycin, trimethoprim-sulfamethoxazole (TMP-SMZ), rifampin, levofloxacin,[scielo.br]
  • (b) Gram stain revealing characteristic small, Gram-positive rods or coccobacilli ( 100 magnification). Identification of Listeria spp. is important to allow for appropriate de-escalation or optimization of antimicrobial therapy.[jcm.asm.org]
  • positive rods Listeria MANAGEMENT Empiric Treatment antibiotics within 30 min of initial assessment dexamethasone 0.15mg/kg Q6 hourly with or before the first dose of antibiotics ceftriaxone (immunocompetent) or vancomycin ciprofloxacin/moxifloxacin[lifeinthefastlane.com]
Gram-Positive Bacteria
  • SLE patients who had a cerebrospinal fluid (CSF) culture positive for L. monocytogenes or other gram-positive bacteria were included. All patients fulfilled at least 4 ACR criteria for SLE.[acrabstracts.org]
  • High degree of alert is essential among clinicians and microbiologists whenever gram variable or Gram-positive bacteria are noticed on Gram-stain. References 1. Swaminathan B, Gerner-Smidt P. The epidemiology of human listeriosis.[ijhas.in]
  • Italian Journal of Pediatrics 2018 44 :152 The Author(s). 2018 Received: 4 October 2018 Accepted: 10 December 2018 Published: 29 December 2018 Abstract Background Listeria monocytogenes is a gram-positive bacteria generally transmitted to humans through[ijponline.biomedcentral.com]
Atrioventricular Dissociation
  • In the setting of increased intracranial pressure (ICP), various rhythm disturbances have been associated, ranging from tachyarrhythmias to bradyarrhythmias with atrioventricular dissociation.[ncbi.nlm.nih.gov]
Brain Edema
  • The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive[books.google.ro]
  • In children with bacterial meningitis and hyponatremia, fluid restriction does not improve either brain edema or outcome [ 39 ].[academic.oup.com]

Treatment

  • Ampicillin with or without an aminoglycoside remains the best treatment for listeriosis.[ncbi.nlm.nih.gov]
  • The authors report two cases of this disease and review the diagnosis and treatment of meningitis in general and, more specifically, of listeric meningitis in pregnancy.[ncbi.nlm.nih.gov]
  • The two other newborns showed complete recovery following adequate treatment.[ncbi.nlm.nih.gov]
  • Infections in the cerebrospinal fluid (CSF) occur in an area of impaired host defenses; therefore, bactericidal antibiotics that reach adequate concentrations in the CSF are necessary for treatment.[ncbi.nlm.nih.gov]
  • The listeria meningitis quickly responded to antimicrobial treatment with intravenous amoxicillin combined with tobramycin.[ncbi.nlm.nih.gov]

Prognosis

  • We also review literature reports of this condition in post-neonatal immunocompetent children, published in English since 1996, in order to discuss its clinical presentation, diagnosis, treatment options and prognosis.[ijponline.biomedcentral.com]
  • The meningitis caused by L. monocytogenes differs from other types of bacterial meningitis, especially in treatment and prognosis. L. monocytogenes meningitis has been mostly reported at the extremes of life.[scielo.br]
  • MRI T1 : hypo to isointense lesion T2/FLAIR : hyperintense DWI : hyperintense/hypointense on ADC map T1 C : linear cranial nerve enhancement ring enhancement (abscess) heterogeneous if extensive inflammation Treatment and prognosis It is reported to have[radiopaedia.org]
  • What is the outlook (prognosis)? Most cases of listeriosis in healthy adults and children are mild and only last for a short time with full recovery. Infection in babies often has a poor outlook.[patient.info]

Etiology

  • Although some cases of other etiologies were also reported, this report informs those who manage patients with meningitis that not only Mycobacterium and Brucella spp. but also other facultative agents can increase ADA levels in cerebrospinal fluid, possibly[ncbi.nlm.nih.gov]
  • The presence of a brain stem abscess should especially alert the clinician to the Listeria as the possible etiology of the infection.[ahcmedia.com]
  • The remaining bacterial etiologic agents include other enteric Gram-negative organisms, as well as enterococci.[jcm.asm.org]
  • Etiology Listeria monocytogenes is an anaerobic and gram-positive bacillus.[radiopaedia.org]
  • One should remember that it is always resistant to cephalosporins which are frequently used in the empirical treatment of bacterial meningitis of unknown etiology. [9] Because of morphological resemblance of diptheroid species, L. monocytogenes could[ijhas.in]

Epidemiology

  • Our data can be used in the future as an epidemiological survey.[ncbi.nlm.nih.gov]
  • The epidemiologic implication of this observation is discussed.[ncbi.nlm.nih.gov]
  • Contrary to the conventional epidemiology these patients were adults who were not immuno-compromised. Although all four cases produced positive cerebrospinal fluid cultures, in three, listeria was not microscopically identified.[pmj.bmj.com]
  • It would be the first illness and death tied to a recent Listeria recall if epidemiological tests establish a link. Shortly after she was born, little Kennedy Grace Briggs had difficulty breathing and developed a rash.[foodpoisoningbulletin.com]
  • Meningitis in Systemic Lupus Erythematosus Patients: Epidemiologic Profile of Listeria Monocytogenes Infection. a Single-Center Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). .[acrabstracts.org]
Sex distribution
Age distribution

Pathophysiology

  • The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive[books.google.ro]
  • : transplacental transmission during pregnancy ; or direct contact with infected vaginal secretions during birth Incubation time: 3–70 days (usually within a month) Risk factors Immunodeficiency Age 60 Pregnancy Neonates References: [1] [2] [3] [4] Pathophysiology[amboss.com]
  • Authors’ Affiliations (1) Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy References Villa G, Diana MC,[ijponline.biomedcentral.com]

Prevention

  • Because the majority of listeria infections occur in patients who are immunosuppressed, it would be reasonable to provide education for healthcare professionals on preventing these infections in all patients receiving immunosuppressants, including anti-TNF-alpha[ncbi.nlm.nih.gov]
  • Blue Bell recalled all of its products last month after the Centers for Disease Control and Prevention found listeria bacteria in several frozen treat items produced in Blue Bell’s plants.[consumerist.com]
  • The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal.[books.google.ro]
  • Prevention Only by not being exposed to contaminated food? Other clinical infections with these organisms Neonatal infections Puerperal infections Granulomatosis infantiseptica[meddean.luc.edu]
  • Some types of bacterial meningitis can be prevented through immunizations . There are vaccines that protect against pneumococcus, meningococcus, and Hib, all of which cause meningitis. Vaccinations are key to the prevention of meningitis.[healthline.com]

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