Listeria meningitis

Glucose >50% of the serum values Acute bacterial meningitis Tuberculosis meningitis Cryptococcal meningitis Listeria meningitis Neurosarcoidosis ... 

Kamath BM, Mamula P, Baldassano RN, Markowitz JE. Listeria meningitis after treatment with infliximab. J Pediatr Gastroenterol Nutr 2002 34(4) 410-12. 

Infection risk In a study of consolidation therapy with subcutaneous alemtuzumab after fludarabine and rituximab induction therapy for previously untreated chronic lymphocytic leukemia, alemtuzumab was associated with five deaths resulting from infections (viral, Listeria meningitis and Legionella, cytomegalovirus, and Pneumocystis jirovedi pnemnonia), which occurred up to 7 months after the last administration [bS "]. 

CNS infections may be caused by a variety of bacteria, fungi, viruses, and parasites. The most common causes of bacterial meningitis include Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, and Haemophilus influenzae. 

In most cases one week of i.v. penicillin is adequate for meningococal meningitis. Ten to 14 days is recommended for pneumococcal meningitis. Two to 3 weeks for Listeria and group B streptococcal meningitis and 3 weeks is necessary for gramnegative meningitis. 

Listeria monocytogenes is the cause of listeriosis, which has a fatality rate of up to 30%. The most frequent effects are meningitis and miscarriage or meningitis of the fetus or newborn. Many types of foods have been implicated in listeriosis cases. Often, a prolonged refrigeration period seems to have contributed to outbreaks. 

A very high dose of amoxicillin (250 mg/kg/day for Listeria monocytogenes meningitis) combined with an aminoglycoside led to crystal-induced acute renal insufficiency after 14 days (118). 

When selecting antibiotics, the clinician must consider the antibiotic concentration at the site of infection, as well as the spectrum of antibacterial activity. Empirical choices should be based on age and predisposing conditions, (a) Ceftriaxone or cefotaxime and vancomycin are reasonable initial choices for empirical coverage of community-acquired meningitis in adult patients, (b) Listeria monocytogenes... 

L. monocytogenes is a gram-positive diphtheroid-like organism responsible for 8% of all reported cases of meningitis. This disease primarily affects neonates, alcoholics, immunocompromised adults, and the elderly. Infections caused by Listeria in healthy individuals are extremely rare. L. monocytogenes is implicated in 20% of meningitis cases in those older than 60 years of age and carries a case-fatality rate of approximately 15%. ... 

The presence of diphtheroid-like gram-positive rods in the cerebrospinal fluid smear of an 82-year-old patient is indicative of the presence of Listeria monocytogenes. In addition to their role as a potential causative agent in neonatal meningitis, listeria infections are more common in elderly patients and in those who have been treated with immunosuppressive agents. Treatment consists of ampicillin with or without gentamicin. Resistant strains are rare. The answer is (A). 

Listeriosis A type of meningitis caused by Listeria monocytogenes that is especially threatening to those with impaired immune systems. 

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