Vrbić Miodrag, Dinić Marina, Jovanović Maja, Ranković Aleksandar, Popović-Dragonjić Lidija, Djordjević-Spasić Marina
Clinic for Infectious Diseases, Clinical Centre Nis, Nis, Serbia.
Vojnosanit Pregl. 2013 Oct;70(10):976-8. doi: 10.2298/vsp1310976v.
Listeria monoytogenes is the third most frequent cause of bacterial meningitis in adults. It commonly affects persons with defective cell-mediated immunity or advanced age, and only a few patiens with no underlying predisposition have been reported.
We presented an previously healthy, 18-year-old man with typical clinical features of meningitis. On the account of earlier treatment with ceftriaxone and cerebrospinal fluid finding, an assumption of partially treated bacterial meningitis was made. The initial treatment with vancomycin and ceftriaxone, substituted on day 4 with meropenem, did not produce any clinical effect. On day 6 Listeria monocytogenes was isolated and, even as late as that, the administration of ampicillin was followed by complete recovery of the patient.
In younger, immunocompetent individuals, in spite of the existent diagnostic and therapeutic problems, the subacute course of Listeria monocytogenes meningitis provides enough time for appropriate treatment and favorable disease outcome.
单核细胞增生李斯特菌是成人细菌性脑膜炎的第三大常见病因。它通常影响细胞介导免疫功能缺陷者或老年人，仅有少数无潜在易患因素的患者被报道过。
我们报告了一名此前健康的18岁男性，他具有典型的脑膜炎临床特征。鉴于早期使用头孢曲松治疗及脑脊液检查结果，推测为部分治疗的细菌性脑膜炎。最初用万古霉素和头孢曲松治疗，第4天换用美罗培南，但未产生任何临床效果。第6天分离出单核细胞增生李斯特菌，即便如此之晚，给予氨苄西林后患者仍完全康复。
在较年轻、免疫功能正常的个体中，尽管存在诊断和治疗问题，但单核细胞增生李斯特菌脑膜炎的亚急性病程为适当治疗和良好的疾病转归提供了足够时间。
