Meningitis and septicemia due to Listeria monocytogenes

Abstract

Listeria monocytogenes (Lm) is a gram-positive bacillus considered opportunistic. It particularly affects pregnant women, newborns, the elderly and  immunocompromised and can cause a wide range  of clinical manifestations ranging from  febrile syndrome to a severe invasive disease that includes bacteremia, sepsis, meningitis and meningoencephalitis. We present the case of an adult male patient with a history of hypertension, psoriasis, cirrhosis and insulin-dependent type II diabetes who i was admitted to intensive care at Hospital J. m. Cullen with feverish symptoms, asthenia, psychomotor excitement, and temporal-spatial disorientation associated with  neck stiffness. Blood, urine, and CSF samples were taken for culture, and empirical treatment with ceftriaxone and vancpmycin was indicated..In the Gram staining of the CSF and blood culture samples, the presence of positive bacilli was observed. In the cultures they developed small and greyish colonies that were identified by automated method Phoenix 100 (BD) and conventional phenotypic test such as Lm. Against this result the medication was rotated to ampicillin and gentamicin. . The patient evolved favorably and once  treatment was completed, he was discharged without sequelae. It is important to perform a thorough anamnesis and suspect rare bacteria such as Lm, which can cause treatment failures whit the initial empirical therapy. Key words: Listeria monocytogenes, meningitis, bacteremia.