Listeriosis of the Central nervous system

Abstract

Object. To study the main causes of severe course and high mortality in patients with nervous form of listeriosis. Materials and methods. The analysis of the course of Listeria meningoencephalitis (LM) in 36 patients aged from 9 to 85 years, who were treated in the Infectious clinical hospital No. 2 DZM (IKB No. 2 DZM). Along with standard examination methods, blood and cerebrospinal fluid (CSF) polymerase chain reaction tests were performed to identify Listeria monocytogenes. The sensitivity of the pathogen to antibiotics was determined by serial dilutions on the WalkAway 96 Plus device of Siemens, USA. Results. LM in 84% of cases developed in patients with disorders in the immune system, in particular, with infection with the human immunodeficiency virus - in 25% of cases. The clinical picture of the disease, changes in CSF were not typical for bacterial purulent meningitis of another etiology. It is noted that LM is characterized by early involvement of the substance and ventricles of the brain in the process. Conclusion. Severe course and high mortality are due to atypical picture of the disease, late diagnosis, low bioavailability of the pathogen for antibiotics (intracellular persistence of the pathogen) and frequent resistance to them. The mortality from the nervous form of listeriosis was 33.3%.

Keywords

• listeriosis
• meningoencephalitis
• immunodeficiency
• diagnosis
• cerebrospinal fluid
• antibiotic resistance