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KMID : 0311120070480030433
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Yonsei Medical Journal
2007 Volume.48 No. 3 p.433 ~ p.439
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Sepsis and Meningitis due to Listeria Monocytogenes
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Yildiz Orhan
Aygen Bilgehan
Esel Duygu
Kayabas Uner
Alp Emine
Sumerkan Bulent
Doganay Mehmet
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Abstract
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Purpose: This study focused on the effect of immuno-compromising conditions on the clinical presentation of severe listerial infection.
Patients and Methods: Nine human listeriosis cases seen from 1991-2002 were reviewed. All adult patients, from whose blood, peritoneal fluid or cerebrospinal fluid (CSF) the L. monocytogenes was isolated, were included in this retrospective study.
Results: Listeriosis presented as primary sepsis with positive blood cultures in 5 cases and meningitis with positive CSF cultures in 4 cases. All of these patients had at least one underlying disease, most commonly, hematologic malignancy, diabetes mellitus, amyloidosis and hepatic cirrhosis; 55.6% had received immunosuppressive or corticosteroid therapy within a week before the onset of listeriosis. The patients were adults with a mean age of 60 years. Fever, night sweats, chills and lethargy were the most common symptoms; high temperature (> 38°C), tachycardia, meningeal signs and poor conditions in general were the most common findings on admission. The mortality rate was 33.3% and was strictly associated with the severity of the underlying disease. Mortality differences were significant between sepsis (20%) and meningitis (50%) patients.
Conclusion: Listeriosis as an uncommon infection in our region and that immuno- suppressive therapy is an important pre-disposing factor of listeriosis. Sepsis and meningitis were more common in this group of patients and had the highest case-fatality rate for food-borne illnesses.
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KEYWORD
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Listeria monocytogenes, sepsis, meningitis, listeriosis, immunosuppressive
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