Listeria monocytogenes meningitis in an immunocompetent 18-year old patient as a possible diagnostic and therapeutical problem

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.

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ALTERATIONS IN THE GLUCOSE TRANSPORT MECHANISM IN PATIENTS WITH COMPLICATIONS OF BACTERIAL MENINGITIS

PEDIATRICS ◽

10.1542/peds.34.4.491 ◽

1964 ◽

Vol 34 (4) ◽

pp. 491-502

Author(s):

R. D. Brooke Williams

Keyword(s):

Cerebrospinal Fluid ◽

Bacterial Meningitis ◽

Glucose Transport ◽

Intravenous Injection ◽

Transport Mechanism ◽

Spinal Fluid ◽

Normal Pattern ◽

The Third ◽

Glucose Diffusion

Glucose diffusion tests were made on 8 children with bacterial meningitis, in 7 [SEE TABLE IV AND FIG 8. IN SOURCE PDF] of whom the organism had been identified. The results of the tests were correlated with the outcome of the illness. Of 3 patients who recovered without sequelae the glucose diffusion patterns were normal in 2 cases, while the third case had somewhat low curves. In 4 cases of proven bacterial meningitis with complication all the tests were abnormal. Three of these were cases of proven hydrocephalus and there was a reversal of the normal pattern of diffusion for the entry of glucose into the cisternal and lumbar regions. An actual lowering of the cisternal glucose following the intravenous injection of glucose was observed in two cases with initial very low spinal fluid sugars. The hypothesis is proposed that alterations in the blood cerebrospinal fluid barrier perhaps due to increased metabolism of arachnoid lining cells or edema in [SEE FIG 9 IN SOURCE PDF] addition to the action of bacteria and leukocytes contribute to the persistent hypoglycorrhachia seen in complicated cases of bacterial meningitis.

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Rapid detection of Listeria monocytogenes rhombencephalitis in an immunocompetent patient by multiplexed PCR

BMJ Case Reports ◽

10.1136/bcr-2018-225575 ◽

2018 ◽

pp. bcr-2018-225575 ◽

Cited By ~ 1

Author(s):

Rocco J Richards ◽

Matthew S Simon ◽

C Douglas Phillips ◽

Lindsay Lief ◽

Stephen G Jenkins ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Listeria Monocytogenes ◽

Cranial Nerve ◽

Rapid Detection ◽

Brain Mri ◽

Complete Recovery ◽

Immunocompetent Patient ◽

Brainstem Encephalitis ◽

Mri Findings ◽

Multiplexed Pcr

A 46-year-old previously healthy man presented with 1 week of headache, nausea, vomiting and dizziness. He was found to have cranial nerve deficits, his cerebrospinal fluid (CSF) demonstrated a lymphocytic pleocytosis and brain MRI suggested rhombencephalitis. Although Gram stains and cultures of his CSF did not identify a pathogen, Listeria monocytogenes DNA was detected by the FilmArray Meningitis/Encephalitis panel within 2 hours of performing a lumbar puncture. He was treated with ampicillin and gentamicin and had a near-complete recovery. This case highlights the importance of recognising L. monocytogenes infection as a cause of acute cranial nerve impairment with MRI findings suggestive of brainstem encephalitis. It also highlights the frequently atypical CSF profile and low yield of culture in L. monocytogenes rhombencephalitis and the value of multiplex PCR testing of CSF to rapidly identify this pathogen and permit targeted therapy.

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Surgical/orthodontic management of a large mandibular odontogenic keratocyst (OKC)

Dental Update ◽

10.12968/denu.2019.46.5.473 ◽

2019 ◽

Vol 46 (5) ◽

pp. 473-479

Author(s):

Amarpreet Atwal ◽

Hannah Cottom ◽

Peter Doyle ◽

Jonathan Sandler

Keyword(s):

Case Report ◽

Treatment Planning ◽

Clinical Relevance ◽

Multidisciplinary Approach ◽

Odontogenic Keratocyst ◽

Radiographic Examination ◽

Optimal Care ◽

The Third ◽

Appropriate Treatment ◽

General Dental Practitioner

The odontogenic keratocyst (OKC) is the third most common cyst of the jaw. OKCs are benign developmental cysts that are often locally destructive and large at presentation. They are usually identified during radiographic examination and require appropriate treatment planning to ensure optimal care. We present a very challenging case of a 12-year-old boy with a large mandibular OKC. The roots of several teeth were displaced, with both LR3 and LR5 unerupted and severely malpositioned. A multidisciplinary approach was therefore essential in view of the complexity, with joint planning and close liaison of treatment between the surgeon, orthodontist and general dental practitioner (GDP). This was fundamental to ensure the best possible outcome was achieved for the patient. CPD/Clinical Relevance: This case report aims to increase awareness of OKCs to GDPs and outlines the surgical, orthodontic and restorative challenges faced in the management of such cases.

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Listeria monocytogenes meningitis in an immunocompetent adult: a case report

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822012000300028 ◽

2012 ◽

Vol 45 (3) ◽

pp. 410-411 ◽

Cited By ~ 4

Author(s):

Yi Zhang ◽

Guo-Qing Zang ◽

Zheng-Hao Tang ◽

Yong-Sheng Yu

Keyword(s):

Case Report ◽

Listeria Monocytogenes ◽

Bacterial Meningitis ◽

Antibiotic Treatment ◽

Immunocompetent Adult ◽

Empirical Antibiotic Treatment ◽

Increased Risk ◽

Invasive Diseases ◽

Old Adult ◽

Immunocompetent Adults

Listeria monocytogenes (L. monocytogenes) is an uncommon cause of bacterial meningitis in immunocompetent adults. Patients with immunosuppression are at increased risk of developing serious invasive diseases, particularly meningitis. We describe a case of meningitis caused by L. monocytogenes in an immunocompetent and previously healthy 34-year-old adult. The patient received treatment with intravenous ampicillin plus amikacin and made a full recovery. L. monocytogenes should be suspected in immunocompetent adults with bacterial meningitis who fail to respond to empirical antibiotic treatment.

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Culture NegativeListeria monocytogenesMeningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy

Case Reports in Neurological Medicine ◽

10.1155/2015/248302 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Shahin Gaini ◽

Gunn Hege Karlsen ◽

Anirban Nandy ◽

Heidi Madsen ◽

Debes Hammershaimb Christiansen ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Cerebrospinal Fluid ◽

Listeria Monocytogenes ◽

Bacterial Meningitis ◽

Penicillin Allergy ◽

Ventricular Catheter ◽

Chain Reaction ◽

Neck Stiffness ◽

Neurological Sequelae ◽

Polymerase Chain

A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy for bacteria, no bacterial growth, and negative polymerase chain reaction for bacterial DNA. The patient developed hydrocephalus on a second CT scan of the brain on the 5th day of admission. An external ventricular catheter was inserted andListeria monocytogenesgrew in the cerebrospinal fluid from the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically forListeria monocytogenesin all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection and inflammation even with negative microscopy, negative cultures, and negative broad range polymerase chain reaction in cases ofListeriameningitis. Follow-up spinal taps can be necessary to detect the presence ofListeria monocytogenes.

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Immunocompromised Child on Infliximab: A Case Report of Listeria monocytogenes Meningitis

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.7.48053 ◽

2020 ◽

Vol 4 (4) ◽

pp. 530-532

Author(s):

Camille Halfman ◽

Luke Slate ◽

Julienne Yamamoto ◽

Samantha Jones

Keyword(s):

Case Report ◽

Listeria Monocytogenes ◽

Central Nervous System Infection ◽

Cell Mediated Immunity ◽

Chain Reaction ◽

Naturally Occurring ◽

Immunocompromised Child ◽

Polymerase Chain ◽

Immunosuppressant Medications ◽

Culture Positive

Introduction: Patients with naturally occurring, impaired cell-mediated immunity secondary to age and pregnancy are known to be at risk of developing severe and invasive Listeria monocytogenes infections. Immunosuppressant medications, particularly infliximab, are also known to increase this risk. Case Report: We present the case of a seven-year-old female on infliximab who was diagnosed with culture positive L. monocytogenes meningitis after a negative cerebral spinal fluid polymerase chain reaction (PCR). Conclusion: Patients receiving infliximab who display signs of central nervous system infection should be suspected to have L. monocytogenes as an infecting agent, and empiric addition of ampicillin to their antibiotic regimen should be considered, with substitution of trimethoprim-sulfamethoxazole in cases of penicillin allergy, regardless of initial PCR results.

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When is surgical resection alone appropriate treatment for pediatric nodular lymphocyte-predominant Hodgkin lymphoma?

SAGE Open Medical Case Reports ◽

10.1177/2050313x211022422 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110224

Author(s):

Sarah Y Bessen ◽

Juli-Anne Gardner ◽

Eunice Y Chen

Keyword(s):

Case Report ◽

Hodgkin Lymphoma ◽

Surgical Resection ◽

Pediatric Patient ◽

Initial Treatment ◽

Early Stage ◽

Primary Treatment ◽

Appropriate Treatment ◽

Pros And Cons

The surgeon’s role in the management of lymphoma is typically limited to performing biopsies for diagnosis. Most patients with lymphoma are treated with chemotherapy and/or radiation, but in rare cases, lymphoma can be primarily treated with surgery. We present a case of nodular lymphocyte-predominant Hodgkin lymphoma in a 4-year-old child with cervical adenopathy and discuss initial treatment with surgery alone. Surgery as primary treatment avoids the serious long-term sequelae of chemotherapy and radiation, and reserves those options for possible future recurrences; however, this approach should be reserved for patients with limited and low-risk disease. This case report reviews the pros and cons of treating early-stage nodular lymphocyte-predominant Hodgkin lymphoma in a pediatric patient with surgery alone.

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Acute Hydrocephalus and Death Following V-P Shunt Disconnection

PEDIATRICS ◽

10.1542/peds.64.1.90 ◽

1979 ◽

Vol 64 (1) ◽

pp. 90-93

Author(s):

Alan Neuren ◽

Patricia H. Ellison

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Bacterial Meningitis ◽

Male Infant ◽

Communicating Hydrocephalus ◽

Complete Obstruction ◽

Ventriculoperitoneal Shunts ◽

Acute Hydrocephalus ◽

The Many

Acute hydrocephalus was described following sudden complete obstruction of cerebrospinal fluid (CSF) pathways.1 This is one of the many complications that have been reported with ventriculoperitoneal shunts.2 Rarely are these acutely lifethreatening. We report a case of acute hydrocephalus after sudden disconnection of a ventriculopertoneal shunt with subsequent death of the child. See Images in the PDF file CASE REPORT A 5-month-old male infant developed bacterial meningitis in February 1976. Two months later, a ventriculoperitoneal shunt was inserted for treatment of progressive communicating hydrocephalus. On a follow-up examination in October 1976, he was reported to be mildly delayed without other neurologic handicap.

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Perawatan maloklusi Klas III pada usia tumbuh kembang

Journal of Dentomaxillofacial Science ◽

10.15562/jdmfs.v9i2.243 ◽

2010 ◽

Vol 9 (2) ◽

pp. 130

Author(s):

Nada Ismah

Keyword(s):

Case Report ◽

Treatment Period ◽

Initial Treatment ◽

Treatment Time ◽

Class Iii ◽

Class Iii Malocclusion ◽

Appropriate Treatment ◽

Growing Age ◽

Proper Diagnosis ◽

Clinical Conditions

Various controversies arise on the appropriate treatment time to treat class IIImalocclusion at the development age. One reason for delay is that the treatment willmake the treatment period longer. Nevertheless, there are other reasons that believethe class III malocclusion must be treated as soon as possible. Accuracy ofexamination is required to obtain the proper diagnosis to determine treatmentoptions. Clinical conditions found in the class III malocclusion can be underdevelopedof maxillae, overdeveloped the mandible, or combination of both. Treatment of classIII malocclusion at the growing age may prevent further severity. A case report of 11yearold boy with class III malocclusion. He is treated with fixed orthodontics toremove obstruction on the maxillae growth. Many treated progression are obtained,although it is still continuing to be continued to maintain the treatmentstabilization. Initial treatment for the class III Malocclusion at the growing age canprevent further severity.

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Case report of Listeria monocytogenes meningoencephalitis in general hospital "Dr Radivoj Simonovic" Sombor

Medicinski pregled ◽

10.2298/mpns1412407c ◽

2014 ◽

Vol 67 (11-12) ◽

pp. 407-409

Author(s):

Snezana Delic ◽

Snezana Brkic ◽

Aleksandar Delic ◽

Ivana Cirkovic

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Case Report ◽

Listeria Monocytogenes ◽

Therapeutic Option ◽

Complete Recovery ◽

Antimicrobial Treatment ◽

Test Method ◽

Central Nervous System Infections ◽

Isolation And Identification

Introduction. Listeria monocytogenes is one of the most common causes of bacterial central nervous system infections in adults. It often affects immunicompromised and elderly patients. Even with appropriate antimicrobial treatment, mortality due to Listeria monocytogenes meningoencephalitis is among the highest of all causes of bacterial central nervous system infections. Case report. We presented a previously healthy, 79-year-old farmer with typical clinical features of meningoencephalitis. The initial treatment with vancomycin and meropenem did not produce any clinical effect. On day six, Listeria monocytogenes was isolated from the cerebrospinal fluid and blood culture and identified by using conventional and automated microbiology methods. Antimicrobial susceptibility testing was performed by E test method. After bacterial isolation and identification, the administration of ampicillin and gentamicin was followed by the complete recovery of our patient. Conclusion. This case is presented to emphasize the negative outcome of empirical treatment when Listeria monocytogenes is not taken into consideration. Furthermore, the administration of ampicillin and gentamicin combination for treatment should be considered as the best therapeutic option in Listeria monocytogenes meningoencephalitis.

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