Listeria monocytogenes meningitis. Case report of a patient with occupational exposure

摘要

At present, L. monocytogenes is considered as one of the most important food-borne pathogens. Human pathogenicity of L. monocytogenes includes a series of characters that aggravate the primary intestinal aggressivity through blood dissemination and passage of blood-brain barrier and placenta. Invasive listeriosis may occur as meningitis, encephalitis, sepsis or abortion, with high mortality rates. This paper presents a clinical case of sepsis with meningeal dissemination caused by L. monocytogenes in a food industry worker. The patient was admitted with the diagnosis of acute bacterial meningo- encephalitis. 72 hours after hospital admission (9 days after symptom onset), the first suspicion of listeriosis was formulated. The bacteriological examination of the cerebrospinal fluid (CSF) confirmed the presumptive diagnosis by the isolation and identification of L. monocytogenes. The bacteriologic diagnosis was further confirmed by MALDITOF mass spectrometry (BruckerDaltomix-Germany).The initial antibiotic treatment (with cefort and vancomycin) was replaced by ampicillin, which led to a spectacular improvement of the clinical status within 24 hours. This paper underlines the importance of anearly clinical and bacteriological diagnosisfor the treatment and prognosis of community acquired listeriosis (including occupational risk cases).