REVIEW – October 2004

Listeria meningoencephalitis


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Listeria is increasing as an important cause of the infection of the central nervous system. In 2003, three cases of Listeria meningoencephalitis were hospitalised in the neurointensive care unit of Tartu University Clinics. In case 1, the patient was admitted in a critical condition, he had a rapid course with comatous status, terminating fatally on the fourth day of hospitalisation. Both other patients had typical clinical features of rhombencephalitis with cranial nerve deficits, cerebellar signs, and hemiparesis, with additional hydrocephalus and ventriculitis. In all cases, Listeria monocytogenes as the cause of infection was confirmed on the microbiological examination of the spinal fluid. Despite specific intravenous antibiotic treatment with Ampicillin after confirmation of the diagnosis, all three patients had lethal outcome. These three recent cases of Listeria meningoencephalitis highlight the increasing importance of this infection. Clinicians should be familiar with the specific clinical and neuroradiological features of this disease, which has high mortality rate, in order to recognise and manage it successfully.