Wu GX, Zhou JY, Hong WJ, Huang J, Yan SQ. Treatment failure in a patient infected with Listeria sepsis combined with latent meningitis: A case report. World J Clin Cases 2022; 10(29): 10565-10574 [PMID: 36312510 DOI: 10.12998/wjcc.v10.i29.10565]
Corresponding Author of This Article
Shuang-Quan Yan, PhD, Chief Doctor, Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province, No. 1 East Tongyang Road, Enze Hospital, Luqiao District, Taizhou 318050, Zhejiang Province, China. yansq@enzemed.com
Research Domain of This Article
Microbiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2022; 10(29): 10565-10574 Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10565
Treatment failure in a patient infected with Listeria sepsis combined with latent meningitis: A case report
Gui-Xian Wu, Jian-Ya Zhou, Wei-Jun Hong, Jing Huang, Shuang-Quan Yan
Gui-Xian Wu, Jing Huang, Shuang-Quan Yan, Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province, Zhejiang University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou 318050, Zhejiang Province, China
Jian-Ya Zhou, Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Wei-Jun Hong, Neurology Department, Taizhou Hospital of Zhejiang Province, Zhejiang University, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou 318050, Zhejiang Province, China
Author contributions: Wu GX and Yan SQ were the physicians in charge of the patient and participated in the entire management of the patient during his hospital stay in the Department of Respiratory Medicine; Wu GX was responsible for the writing and revision of the article; Yan SQ was responsible for the quality control of the article; Hong WJ provided clinical guidance and image analysis for intracranial infection; Zhou JY provided clinical treatment guidance; All authors have read and approve the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shuang-Quan Yan, PhD, Chief Doctor, Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province, No. 1 East Tongyang Road, Enze Hospital, Luqiao District, Taizhou 318050, Zhejiang Province, China. yansq@enzemed.com
Received: November 4, 2021 Peer-review started: November 4, 2021 First decision: March 7, 2022 Revised: March 20, 2022 Accepted: August 30, 2022 Article in press: August 30, 2022 Published online: October 16, 2022 Processing time: 329 Days and 0.3 Hours
Abstract
BACKGROUND
Listeria is a food-borne disease, which is rarely prevalent in the normal population; it mostly occurs in pregnant women, newborns, immunodeficiency patients, and the elderly. The main manifestations of this disease in patients include sepsis, meningitis, etc, and the mortality rate remains high, although the onset of meningitis is relatively insidious.
CASE SUMMARY
A 75-year-old man presented with a fever for 1 wk and was admitted to the hospital for diagnosis and management of a lung infection. His condition improved after receiving anti-infective treatment for 2 wk. However, soon after he was discharged from the hospital, he developed fever again, and gradually developed various neurological symptoms, impaired consciousness, and stiff neck. Thereafter, through the cerebrospinal fluid metagenomic testing and blood culture, the patient was diagnosed with Listeria monocytogenes meningitis and sepsis. The patient died after being given active treatment, which included penicillin application and invasive respiratory support.
CONCLUSION
This case highlights the ultimate importance of early identification and timely application of the various sensitive antibiotics, such as penicillin, vancomycin, meropenem, etc. Therefore, for high-risk populations with unknown causes of fever, multiple blood cultures, timely cerebrospinal fluid examination, and metagenomic detection technology can assist in confirming the diagnosis quickly, thereby guiding the proper application of antibiotics and improving the prognosis.
Core Tip: Listeria is a considered a food-borne disease but is rarely prevalent in the normal population. We present herein, a rare case of meningoencephalitis caused by Listeria monocytogenes (L. monocytogenes) that evolved in a previously healthy immunocompetent old male patient. Both the cerebrospinal fluid metagenomic test and bilateral blood culture test results suggested the occurrence of L. monocytogenes. The findings of this case highlight the ultimate importance of early identification and timely application of sensitive antibiotics. Therefore, for high-risk populations with unknown causes of fever, multiple blood cultures, timely cerebrospinal fluid examination, and metagenomic detection technology can assist in confirming the diagnosis quickly, which can facilitate the application of suitable antibiotics and significantly improve the prognosis.
