Three Adult Cases of Listeria monocytogenes Meningitis in Vietnam e1000306

• Published in: PLoS medicine Vol. 7; no. 7
• Main Authors: Chau, Tran ThiHong, Campbell, James I, Schultsz, Constance, Chau, Nguyen VanVinh, Diep, To Song, Baker, Stephen, Chinh, Nguyen Tran, Farrar, Jeremy J, Doorn, H Rogiervan
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 01.07.2010
• Subjects: Bacteria; Coma; Dairy products; Developing countries; Disease; Fever; Glucose; Headaches; Health care; Illnesses; Infections; LDCs; Listeria; Medical diagnosis; Medical imaging; Meningitis; Microscopy; Mortality; Patients; Tropical diseases; Vietnam; East Asia
• ISSN: 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1000306

Abbreviations: CSF, cerebrospinal fluid; GCS, Glasgow Coma Scale; HCMC, Ho Chi Minh City; HTD, Hospital for Tropical Diseases; LP, lumbar puncture; ZN, Ziehl-Neelsen Provenance: Not commissioned; externally peer reviewed Description of Cases Patient 1: A 77-y-old male from Ho Chi Minh City (HCMC), Viet Nam, with a history of (compensated) cirrhosis and noninsulin-dependent diabetes, presented to a district hospital with a 3-d history of fever and headaches, followed by unconsciousness. The three patients presented were seen within a period of 1 y. Of the ~500 patients with a syndrome of fever, headache or neck-stiffness, and GCS alterations who are admitted to HTD each year, approximately 50% are diagnosed with viral encephalitis on the basis of blood and CSF values, especially a relatively low CSF white cell count (<1,000/µl), in combination with normal CSF glucose (>50% of blood level), and normal CSF protein and CSF lactate. Key Learning Points * Listeriosis is a foodborne infection caused by Listeria monocytogenes that presents with a sepsis-like syndrome or as an acute-to-subacute central nervous system infection, mostly meningitis, with a 20%-30% mortality despite adequate treatment. * Listeriosis in the developed world has most commonly occurred at the extremes of life (in neonates by vertical transmission or in the elderly), during severe immune suppression, and especially during pregnancy.