Introduction. Listeria monocytogenes is the third most frequent cause of
bacterial meningitis in adults. It commonly affects persons with defective
cell-mediated immunity or advanced age, and only a few patients with no
underlying predisposition have been reported. Case report. We presented an
previously healthy, 18-year-old man with typical clinical features of
meningitis. On the account of earlier treatment with ceftriaxone and
cerebrospinal fluid finding, an assumption of partially treated bacterial
meningitis was made. The initial treatment with vancomycin and ceftriaxone,
substituted on day 4 with meropenem, did not produce any clinical effect. On
day 6 Listeria monocytogenes was isolated and, even as late as that, the
administration of ampicillin was followed by complete recovery of the
patient. Conclusion. In younger, immunocompetent individuals, in spite of the
existent diagnostic and therapeutic problems, the subacute course of Listeria
monocytogenes meningitis provides enough time for appropriate treatment and
favorable disease outcome.
Hyper-acute neurogenic pulmonary oedema in a prehospital setting: a case report
