Bir Yenidoğanda PCR İle Tanı Konulan Listeria monocytogenes Menenjiti

Yıl 2021, , 315 - 317, 05.06.2021

Meltem Karabay , İrem Türkoğlu Kuzu , Mehmet Köroğlu , İbrahim Caner

https://doi.org/10.26453/otjhs.853879

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

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

A Listeria monocytogenes Newborn Meningitis Diagnosed by PCR

Öz

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.

Anahtar Kelimeler

Listeria monocytogenes, meningitis, newborn

Proje Numarası

yok

Kaynakça

• Shruthi Matle I, Mbatha KR, Madoroba E. A review of Listeria monocytogenes from meat and meat products: Epidemiology, virulence factors, antimicrobial resistance and diagnosis. Onderstepoort J Vet Res. 2020;87(1):1-20.
• Chrétien R, Voide C, Bally F. Outbreak of listeriosis in Valais, 2020: review of causes of food contamination. Rev Med Suisse. 2020;16 (710):1926-1931.
• Mylonakis E, Paliou M, Hohmann EL, Calderwood SB, Wing EJ. Listeriosis during pregnancy: a case series and review of 222 cases. Medicine (Baltimore). 2002 ;81(4):260-9. doi: 10.1097/00005792-200207000-00002.
• Brouwer MC, van de Beek D, Heckenberg SGB, Spanjaard L, de Gans J. Communityacquired Listeria monocytogenes meningitis in adults. Clin Infect Dis. 2006;43(10):1233-1238.
• Akpolat NÖ, Elci S, Atmaca S, Gül K. Listeria monocytogenes in products of animal origin in Turkey. Vet Res Commun. 2004;28(7):561– 567.
• Marth EH, Steele, J. Applied Dairy Microbiology. 2nd ed. Texas, TX: CRC Press; 2001.
• Rugna G, Carra E, Bergamini F, et al. Distribution, virulence, genotypic characteristics and antibiotic resistance of Listeria monocytogenes isolated over one-year monitoring from two pig slaughterhouses and processing plants and their fresh hams. Int J Food Microbiol. 2021;336:108912.
• Mylonakis E, Hohmann EL, Calderwood SB. Central nervous system infection with Listeria monocytogenes: 33 yearsʼ experience at a general hospital and review of 776 episodes from the literature. Medicine. 1998;77(5):313-336.
• Armstrong RW, Fung PC. Brainstem encephalitis (rhombencephalitis) due to Listeria monocytogenes: Case report and review. Clin Infect Dis. 1993;16(5):689-702.
• Leber AL, Everhart K, Balada-Llasat JM, et al. Multicenter evaluation of BioFire FilmArray meningitis/encephalitis panel for detection of bacteria, viruses, and yeast in cerebrospinal fluid specimens. J Clin Microbiol. 2016;54 (9):2251-2261.
• Khater WS, Elabd SH. Identification of Common Bacterial Pathogens Causing Meningitis in Culture-Negative Cerebrospinal Fluid Samples Using Real-Time Polymerase Chain Reaction. Int J Microbiol. 2016; 4197187. doi: 10.1155/2016/4197187.
• Streharova A, Babjakova A, Moravcikova A, et al. Neuroinfections due to Listeria monocytogenes. Neuro Endocrinol Lett. 2007 ;28 Suppl 3:20-21.