A Case of Listeria Monocytogenes Meningitis in an Elderly Female Complicated by Intracerebral Hemorrhage and Hydrocephalus

Abstract

An important bacterial pathogen in foodborne illness is Listeria monocytogenes, which affects immunocompromised patients, pregnant females, and people at the extremes of age, including neonates and elderly. The main clinical manifestations of infection in these hosts are central nervous system (CNS) invasion and bacteremia. In contrary to that, normal hosts who ingest high numbers of Listeria may develop self-limited febrile gastroenteritis. Listeria can lead to unusual and alarming complications such as hydrocephalus and intracerebral hemorrhage (ICH). ICH associated with L. monocytogenes has been observed sporadically. Listeria is the fifth most common cause of meningitis after H.influenzae, S. pneumoniae, N. meningitides and streptococcus group B, although less common. Meningitis caused by monocytogenes was noted to have highest fatality rate of 22%. Adults with listeria meningitis who do not have serious underlying disease or are not on immunosuppressive drugs have a low mortality rate (0-13%). A case of listeria meningitis is presented in this paper. An elderly female aged 74 yeras had bacteremia caused by monocytogenes, which got worsened by intracerebral hemorrhage. She presented at first with indefinite symptoms of fever and vomiting for 10 days and ASOC for 2 days and on later admission presented with sudden deterioration of consciousness which prompted further investigations that showed the presence of ICH.