A rare case of meningoencephalitis by Listeria monocytogenes in systemic lupus erythematosus: case report and review

Abstract

Patients with systemic lupus erythematosus (SLE) have a high risk of infection. Central nervous system infection and neuropsychiatric SLE are both major causes of death. It is vital to distinguish between these two conditions to improve prognosis due to the treatment paradigms required for each condition. Here, we report one case of meningoencephalitis by Listeria monocytogenes (LM) in a patient with SLE who presented with fever and developed headache and altered in consciousness in the hospital. The cerebrospinal fluid culture was positive for LM, and magnetic resonance imaging (MRI) findings were suggestive of ependymitis and periventricular white matter lesions. Amoxicillin/sulbactam, trimethoprim-sulfamethoxazole, and rifampicin were administered for 8 weeks. The patient had a relative good recovery without serious neurological sequelae after a follow-up of nearly 2 years. MRI abnormalities also had obvious resolution.

Basic Analysis of the Cerebrospinal Fluid: An Important Framework for Laboratory Diagnostics of the Impairment of the Central Nervous System

“…Very similar findings in CSF corresponding to mononuclear or lymphocytic pleiocytosis, hyperproteinorhachia, hypoglycorhachia and hyperlactatorhachia have been described in patients with neurotuberculosis, neurolisteriosis and cryptococcal meningitis [ 10 , 19 , 32 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. In contrary, Bicanic and Harrison (2004) reported normal CSF white cell counts in HIV-associated cryptococcal meningitis, probably reflecting inability to mount protective immune response in these patients [ 49 ].…”