Sepsis and meningitis due to Listeria monocytogenes.
OBJECTIVE
This study focused on the effect of immuno-compromising conditions on the clinical presentation of severe listerial infection.


METHODS
Nine human listeriosis cases seen from 1991-2002 were reviewed. All adult patients, from whose blood, peritoneal fluid or cerebrospinal fluid (CSF) the L. monocytogenes was isolated, were included in this retrospective study.


RESULTS
Listeriosis presented as primary sepsis with positive blood cultures in 5 cases and meningitis with positive CSF cultures in 4 cases. All of these patients had at least one underlying disease, most commonly, hematologic malignancy, diabetes mellitus, amyloidosis and hepatic cirrhosis; 55.6% had received immunosuppressive or corticosteroid therapy within a week before the onset of listeriosis. The patients were adults with a mean age of 60 years. Fever, night sweats, chills and lethargy were the most common symptoms; high temperature (> 38 degrees C), tachycardia, meningeal signs and poor conditions in general were the most common findings on admission. The mortality rate was 33.3% and was strictly associated with the severity of the underlying disease. Mortality differences were significant between sepsis (20%) and meningitis (50%) patients.


CONCLUSIONS
Listeriosis as an uncommon infection in our region and that immuno- suppressive therapy is an important pre-disposing factor of listeriosis. Sepsis and meningitis were more common in this group of patients and had the highest case-fatality rate for food-borne illnesses.
Yildiz
Orhan
O
Department of Infectious Diseases, Faculty of Medicine, Erciyes University, 38039 Kayseri, Turkey. oyildiz@erciyes.edu.tr
Aygen
Bilgehan
B
Esel
Duygu
D
Kayabas
Uner
U
Alp
Emine
E
Sumerkan
Bulent
B
Doganay
Mehmet
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001202:Ascitic Fluid / Q000382:microbiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008089:Listeria monocytogenes / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D008088:Listeriosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents