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Listerial Meningitis

Listeria Meningitis


Presentation

  • The patients were aged 53, 51 and 56 years and presented 4, 7 and 90 months post-transplant, respectively.[ncbi.nlm.nih.gov]
  • Symptoms were present for 4 days prior to presentation in 8 (27%) patients.[ahcmedia.com]
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]
  • Intravenous ampicillin improved the symptoms of fever, bloody diarrhea, and headache without any neurological sequelae.[jstage.jst.go.jp]
  • Persisting fever was defined as a body temperature of 38 C for 10 days after the start of appropriate antimicrobial treatment. Recurrent fever was defined as fever reoccurring after at least 1 afebrile day.[academic.oup.com]
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]
  • Listeria can cause flu-like symptoms , including a high temperature, muscle ache or pain, chills, vomiting and diarrhoea. In severe cases it can lead to meningitis.[chroniclelive.co.uk]
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]
  • Symptoms High fever, headache, and stiff neck are common symptoms in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days.[pritzkerlaw.com]
  • However, the high fever persisted and his clinical condition deteriorated.[scielo.br]
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]
  • 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]
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
  • Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness.[pritzkerlaw.com]
  • Listeria can cause flu-like symptoms , including a high temperature, muscle ache or pain, chills, vomiting and diarrhoea. In severe cases it can lead to meningitis.[chroniclelive.co.uk]
  • 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]
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]
  • Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness.[pritzkerlaw.com]
  • Primary clinical picture manifests as intestinal infection - diarrhea, nausea and vomiting [ 2 ].[aclr.com.es]
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]
Diplopia
  • However she noticed diplopia due to left 6th nerve paresis, which resolved over in one-week. On the 12 th day, her CRP was reduced to 2.3 mg/L and ESR came down to 23 mm/1 hour.[esciencecentral.org]
  • A brain MRI was performed because of a suspected increase in the intracranial pressure and the development of diplopia; there were no clinical findings suggestive of brain edema, such as an increase in the size of the ventricles.[ncbi.nlm.nih.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 High fever, headache, and stiff neck are common symptoms in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days.[pritzkerlaw.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]
  • For example, seizures are often more frequent. It can be a long road to being able to walk and communicate well again.[pritzkerlaw.com]
  • Patients with impairment of consciousness, neurological deficits, or seizures, underwent cranial computed tomography (CT) before lumbar puncture.[bmcinfectdis.biomedcentral.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]
  • Patient 3: The patient was transferred back to HTD with a GCS of 15, and persistent neck stiffness.[journals.plos.org]
  • 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]
  • Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness.[pritzkerlaw.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
  • 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]
  • Foods contaminated with Listeria monocytogenes can cause outbreaks of meningitis . Meningitis caused by Listeria monocytogenes bacteria occurs most often in newborns, older adults, and people with long-term illnesses or impaired immune systems .[wa.kaiserpermanente.org]
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]
  • 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]
  • An early presumptive diagnosis of Listeria infection may be possible with close attention to preliminary reports of Gram-positive rods.[neoreviews.aappublications.org]
  • (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]
  • However, it allows only a retrospective diagnosis for listeriosis and lacks specificity, since a false-positive result can be due to cross-reactions with hemolysins from other Gram-positive bacteria.[jcm.asm.org]
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]
  • Listeria infections can be complicated by hydrocephalus and/or brain edema within 1 week of the start of treatment; as was noted in the case presented here.[ncbi.nlm.nih.gov]
  • 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]

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]
  • 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]
  • 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]
  • 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]
  • Since the etiologic importance of this organism can therefore be easily overlooked, it seems desirable to record one additional case. CASE REPORT The patient was a 62 year old woman whose past FULL TEXT[annals.org]
  • 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]

Epidemiology

  • 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]
  • Abstract As part of a collaborative study of the epidemiology of bacterial meningitis, the bacteriological data and some clinical features concerning neonates with Listeria monocytogenes meningitis were analysed for the period 1976–1982.[link.springer.com]
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]
  • Pathophysiology L monocytogenes is a motile, non–spore-forming, gram-positive bacillus that has aerobic and facultatively anaerobic characteristics.[emedicine.medscape.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]
  • Prevention The best way to prevent a Listeria infection is by using careful food preparation techniques. Here are tips for avoiding the bacteria: All meat should be properly cooked. Refrigerate or freeze cooked foods within two hours of preparation.[livescience.com]

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