Clinical presentation and outcome of listeriosis in patients with and without immunosuppressive therapy.
Seventy-four cases of systemic listeriosis occurring from 1971 to 1989 in the greater Helsinki area in Finland are reviewed with a special interest in the effect of preceding immunosuppressive therapy on the clinical presentation. Of these patients, 66% had an underlying disease, most commonly malignancy, diabetes mellitus, or renal transplantation, and 43% had received immunosuppressive therapy within 1 week before onset of listeriosis. Bacteremia and central nervous system infections (both in 43% of cases) were the most common clinical entities. The percentage of patients with meningitis was not greater among immunosuppressed patients (13/32, 41%) than among patients with underlying diseases not treated with immunosuppressive agents (9/16, 56%) or among previously healthy nonpregnant hosts (7/11, 64%). Immunosuppressed patients did not die more frequently than did those with underlying diseases not treated with immunosuppressive therapy (case fatality rate, 29% vs. 38%, respectively). However, all previously healthy non-neonatal patients survived, whereas 32% (15/47) of those with any kind of underlying disease succumbed.
Skogberg
K
K
Department of Bacteriology and Immunology, University of Helsinki, Finland.
Syrjänen
J
J
Jahkola
M
M
Renkonen
O V
OV
Paavonen
J
J
Ahonen
J
J
Kontiainen
S
S
Ruutu
P
P
Valtonen
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000617:Aminoglycosides; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D001799:Blood Sedimentation; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation; D008088:Listeriosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D008584:Meningitis, Listeria / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010400:Penicillin G / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D016896:Treatment Outcome
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000667:Ampicillin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D010400:Penicillin G; D010878:Piperacillin