Listeriosis of the Central nervous system

Abstract

In order to analyze the causes of severe course and high lethality of the nervous form of listeriosis, the features of the course of the disease in 36 patients with listeriotic meningoencephalitis (LM) aged 9 to 85 years were analyzed, 12 (33%) of them died. Along with standard methods of examination, PCR of blood and cerebrospinal fluid (CSF) was carried out for the detection of Listeria monocytogenes, the sensitivity of Listeria to antibiotics was determined by the method of serial dilutions on the WalkAway 96 Plus device of Siemens, USA. It was found that listeriosis developed against the background of disorders in the immune system, in particular in patients with HIV infection. The clinical picture of the disease, changes in CSF were little characteristic of bacterial purulent meningitis of other etiology (BGM). LM is characterized by early involvement of the substance and ventricles of the brain in the process. The severe course and high lethality are due to the atypical picture of the disease, late diagnosis, low bioavailability of the pathogen for antibiotics (intracellular persistence of the pathogen) and frequent resistance to them. The expediency of examination for listeriosis in atypical course of BGM, uncharacteristic changes in CSF and patients with HIV infection with CNS lesion is recommending.