INFECTION OF THE CENTRAL NERVOUS-SYSTEM BY LISTERIA-MONOCYTOGENES - A REVIEW OF 54 ADULT AND JUVENILE CASES

  • 1 January 1984
    • journal article
    • research article
    • Vol. 53  (211) , 331-340
Abstract
The clinical features in 54 juvenile and adult patients with L. monocytogenes infection of the CNS are described. Of the patients 31 had pre-existing chronic disease; the remainder were previously healthy. In the meningo-encephalitic group the 20 patients developed focal neurological signs. The remaining 34, the meningitic group exhibited no focal signs other than those caused by increased intracranial pressure. The meningitic group differed from the meningo-encephalitic group in that the CSF white cell count, protein and glucose levels were markedly more abnormal and the prognosis worse. Evidence of septicemia was found only in the meningitic group. Meningo-encephalitis may represent a modified response to listerial infection typified by granulomatous rather than a suppurative response. The predominance of this response that was demonstrated in females may indicate partial immunity, the result of previous L. monocytogenes colonization of the female genital tract. L. monocytogenes infection is treatable and should be considered in patients with meningitic or encephalitic illness. Repeated blood cultures may be required to establish the diagnosis.

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