title: Severe invasive listeriosis--case report.
abstract: Listeriosis is a rare food borne infection which, in the invasive form, presents as bloodstream infection, central nervous system infection, materno-fetal infection, or focal infection. Certain immunosuppressive conditions have been identified as risk factors for severe invasive disease. The invasive forms of listeriosis are associated with a high case fatality rate. We present the case of a 62-year-old male with an unremarkable medical history admitted to the Iasi Infectious Diseases Hospital for fever. headache, ataxia, and diplopia. Physical examination revealed high temperature, confusion, relative bradycardia, and signs of meningeal irritation. Laboratory test showed leukocyt osis with neutrophilia. pathological CSF findings (high WBC count with predominance of neutrophils, low glucose and high protein levels), increased liver enzymes (ALAT, ASAT, AP, gammaGT), and important renal impairment (normal levels at presentation). No abnormalities at chest x-ray, cranial CT and abdominal ultrasound. CSF and blood cultures were positive for Listeria monocytogenes. Under antibiotics (ampicillin and ciprofloxacin), the course was marked by respiratory failure requiring mechanical ventilation, coma, hypotension, tachycardia. and death 12 days after admission. The particularity of this case consists in the association of the two classical forms of invasive listeriosis, meningitis and bacteriemia, with a focal infection. acute hepatitis, and a course marked by multiple organ dysfunction syndromes and exitus in a previously apparently healthy individual.
authors.affiliation: University of Medicine and Pharmacy Grigore T. Popa-Iasi School of Medicine.
authors.forename: Andra
authors.initials: A
authors.lastname: Teodor
authors.forename: D
authors.initials: D
authors.lastname: Teodor
authors.forename: Egidia
authors.initials: E
authors.lastname: Miftode
authors.forename: D
authors.initials: D
authors.lastname: Prisăcaru
authors.forename: Daniela
authors.initials: D
authors.lastname: Leca
authors.forename: Cristina
authors.initials: C
authors.lastname: Petrovici
authors.forename: Olivia
authors.initials: O
authors.lastname: Dorneanu
authors.forename: Carmen-Mihaela
authors.initials: CM
authors.lastname: Dorobăt
mesh_terms: D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001259:Ataxia / Q000382:microbiology; D016470:Bacteremia / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D002939:Ciprofloxacin / Q000627:therapeutic use; D004172:Diplopia / Q000382:microbiology; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005334:Fever / Q000382:microbiology; D006261:Headache / Q000382:microbiology; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification; D008088:Listeriosis / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008584:Meningitis, Listeria / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000382:microbiology; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D000667:Ampicillin