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一名免疫功能正常的年轻男性同时感染李斯特菌性脑膜炎和脑脓肿与新冠病毒:病例报告

Listerial Meningitis and Brain Abscess With Coexisting COVID-19 Infection in a Young, Immunocompetent Male: A Case Report.

作者信息

Bokhari Syed Faqeer Hussain, Sattar Huma, Abid Shaun, Jaffer Syeda Rabab, Sajid Samar

机构信息

Medicine and Surgery, Mayo Hospital, Lahore, PAK.

Internal Medicine, Sharif Medical & Dental College, Lahore, PAK.

出版信息

Cureus. 2022 Sep 22;14(9):e29455. doi: 10.7759/cureus.29455. eCollection 2022 Sep.

Abstract

(LM) is a gram-positive intracellular pathogen that can cause central nervous system infections such as meningitis, meningoencephalitis, rhombencephalitis, or cerebritis. It rarely causes a brain abscess. Listerial meningitis and brain abscess most commonly occur in immunocompromised individuals, neonates, pregnant females, alcoholics, and the elderly. We present a unique case of a young immunocompetent male who presented with listerial meningitis and brain abscess. Coexisting coronavirus disease 2019 (COVID-19) infection was also present. Since LM was not included in the differentials, the standard antibiotic regimen started for the meningitis therapy was ineffective. Remdesivir was administered to treat the coexisting COVID-19 infection. When the lumbar tap polymerase chain reaction pointed out that the causative agent was , we shifted to ampicillin and gentamicin therapy, to which the patient responded very effectively.LM is an atypical cause of meningitis and brain abscesses. A high index of suspicion is therefore required for early detection and effective treatment of listerial meningitis and brain abscess.

摘要

单核细胞增生李斯特菌(LM)是一种革兰氏阳性细胞内病原体,可引起中枢神经系统感染,如脑膜炎、脑膜脑炎、脑桥炎或脑灰质炎。它很少引起脑脓肿。李斯特菌性脑膜炎和脑脓肿最常见于免疫功能低下者、新生儿、孕妇、酗酒者和老年人。我们报告了一例独特病例,一名年轻的免疫功能正常男性患有李斯特菌性脑膜炎和脑脓肿,同时还存在2019冠状病毒病(COVID-19)感染。由于最初鉴别诊断未考虑到LM,用于脑膜炎治疗的标准抗生素方案无效。于是给予瑞德西韦治疗并存的COVID-19感染。当腰椎穿刺聚合酶链反应指出病原体为LM时,我们改用氨苄西林和庆大霉素治疗,患者对此反应非常有效。LM是脑膜炎和脑脓肿的非典型病因。因此,对于早期发现和有效治疗李斯特菌性脑膜炎和脑脓肿,需要高度的怀疑指数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20a4/9587750/2ae5f22fb0a4/cureus-0014-00000029455-i01.jpg

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