Histopathology of Listeria Meningitis

Abstract

Listeria monocytogenes meningitis is the third most common cause of bacterial meningitis in adults and has high mortality and morbidity rates. We describe the clinical course and score brain pathology of 5 patients who died of listeria meningitis. All patients were immunocompromised and ages ranged between 48 and 76 years. Three cases were confirmed by cerebrospinal fluid culture; one was confirmed by brain culture; and one diagnosis was based on a positive blood culture and neuropathological findings. Mild inflammation of meningeal arteries was found in 3 of 5 cases (60%). Moderate/severe ventriculitis was seen in 4 of 4 cases (100%), abscesses in 3 of 4 cases (75%), mild vascular inflammation in 4 of 5 cases (80%), mild/moderate hemorrhage in 2 of 4 cases (50%), mild/moderate thrombosis of meningeal artery in 3 of 5 cases (60%), and 1 case (25%) showed a moderate infarct. The inflammatory cells present in the meninges were characterized by a mix of monocytes, macrophages, and neutrophils and removal of apoptotic inflammatory cells by macrophages (efferocytosis). Gram stain showed intra- and extracellular presence of rod-shaped bacteria in 3 cases. Pathological examination was characterized by moderate to severe ventriculitis, abscesses and abundant efferocytosis which has been suggested to be exploited by L. monocytogenes for cell-to-cell spread.

Expression of Acute Phase Protein, Glial Fibrillary Acidic Protein, Epithelial Cadherin, and S100 Protein in Brain Tissues from Natural Cases of Ovine Encephalitic Listeriosis

“…Additionally, the reduced or absent palpebral reflexes are due to impairment of the sensitivity component of the trigeminal nerve and the motor component of the facial nerve (Disson & Lecuit, 2012;Wei et al, 2020). In our study, the gross lesions were in the form of cerebro-menengial hemorrhage and gray color liquefied spots; these findings are in agreement with those of previous reports (Maxie & Youssef, 2007; Engelen- Lee et al, 2018).…”

“…These microabscesses can start as a minute microglial reaction or as a small collection of neutrophils, with diffuse perivascular cuffing (composed of lymphocytes, histiocytes, neutrophils, and eosinophils) and meningeal infiltration (Di Palma et al, 2012;Engelen-Lee et al, 2018). This finding is consistent with those of previous studies (Zachary, 2012;Headley et al, 2013;Engelen-Lee et al, 2018). These findings lead us to suggest that L. monocytogenes actively contributes to the etiopathogenesis of brainstem lesions.…”

Listeria monocytogenes at the interface between ruminants and humans: A comparative pathology and pathogenesis review

“…29,40,203 Lesions mainly consist of mild to severe multifocal or diffuse meningeal inflammation with focal cortical infiltration, diffuse ventriculitis with ependymal erosion and focal periventricular infiltration, meningeal and parenchymal vasculitis, thrombosis, and small parenchymal perivascular abscesses. 86 The inflammatory infiltrate is mostly composed of monocytes/ macrophages and neutrophils, with frequent efferocytosis of phagocytes operated by macrophages, while bacteria can be seen intra-and extracellularly in the meninges, parenchymal abscesses, and ependyma. 86 Neurolisteriosis in monogastric mammals and birds is rarely encountered and, like in humans, prevalently manifests as meningoencephalomyelitis in the context of septicemia (Figs.…”

Why Are Some Listeria monocytogenes Genotypes More Likely To Cause Invasive (Brain, Placental) Infection?

“…2 ). Except for the ascending intra-axonal invasion of the rhombencephalon from oropharyngeal cranial nerve terminals, evoked in ruminants and occasionally in people ( 1 , 41 ), neurolisteriosis generally results from hematogenous invasion of the brain ( 42 , 43 ). In systemically infected mice, listerial brain invasion has been shown to critically depend on the level and duration of bacteremia ( 35 ).…”