A Listeria monocytogenes Newborn Meningitis Diagnosed by PCR

Abstract

Listeria monocytogenes is a Gram (+) bacterium that causes sepsis, pneumonia and meningitis in the neonatal period. Our patient was admitted to our clinic with complaints of fever and decreased sucking. In the examination of the patient, his general condition was poor, his fever was 38.8 ° C axillary, his sucking was decreased, and he was bomb with fontanel. Ampicillin and cefotaxime were started with the pre-diagnosis of late neonatal sepsis and meningitis. In the laboratory examination of the patient; leukocyte 17.1x103/mm3, CRP 6 mg/dl, procalcitonin 0.229 ng/ml. Microprotein 291 mg/dl and glucose 27 mg/dl were measured in the cerebrospinal fluid (CSF). In lumbar puncture, CSF pressure was increased, its appearance was blurred and 800 cells per mm3 were detected in cell count. No bacteria were seen in the Gram stain. There was no growth in the CSF and blood samples. L. monocytogenes DNA was detected in CSF by PCR. In this article, it is aimed to present a case of Listeria meningitis diagnosed by PCR in a case whose blood and CSF cultures, Gram staining results and acute phase reactants were negative.

Keywords

• Listeria monocytogenes
• meningitis
• newborn

Bir Yenidoğanda PCR İle Tanı Konulan Listeria monocytogenes Menenjiti

Öz

Listeria monocytogenes yenidoğan döneminde sepsis, pnömoni ve menenjite neden olan Gram (+) bir bakteridir. Hastamız, ateş, emmede azalma şikayetleriyle kliniğimize yatırıldı. Hastanın yapılan muayenesinde genel durumu kötü, ateşi aksiller 38,8 0C, emmesi azalmış, fontaneli bombeydi. Hastaya geç neonatal sepsis ve menenjit ön tanısıyla ampisilin, sefotaksim başlandı. Hastanın laboratuvar incelemesinde; kanda lökosit 17.1x103/mm3, CRP 6 mg/dl, prokalsitonin 0,229 ng/ml. Beyin omurilik sıvısında (BOS) mikroprotein 291 mg/dl, glukoz 27 mg/dl ölçüldü. Hastaya yapılan lomber ponksiyonda BOS basıncı artmış, görünümü bulanık ve hücre sayımında mm3 de 800 hücre tespit edildi. Gram boyamada bakteri görülmedi. BOS ve kan örneklerinde üreme olmadı. PCR ile BOS’ta L. monocytogenes DNA'sı saptandı. Bu yazıda kan ve BOS kültürleri, Gram boyama sonuçları ve akut faz reaktanları negatif olan bir olguda PCR ile tanısı konulan Listeria menenjiti olgusunun sunulması amaçlanmıştır.

Anahtar Kelimeler

• Listeria monocytogenes
• menenjit
• yenidoğan

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