Meningoencephalitis of listeriosis etiology. A case from practice

   Background. Listeriosis is a widespread natural focal infectious disease in humans and animals, characterized by a variety of sources of the causative agent of infection, as well as variability in clinical course and outcomes. The clinical manifestations of the disease are diverse, the most dangerous are the generalized forms – septic and nervous (meningitis, meningoencephalitis), which often develop with generalization of the gastrointestinal form. Constant monitoring allows you to monitor the emergence of new foci of the disease and their spread in the countries of the world, including Russia. Given the emergence of listeriosis outbreaks around the world and the significant severity of the disease, the World Health Organization is actively developing preventive measures.

   Objective. To draw the attention of practitioners of various profiles to the nervous form of listeriosis, which occurs in the form of meningitis and/or meningoencephalitis.

   Materials and methods. The article presents a clinical case with a favorable outcome, describing damage to the central nervous system due to listeriosis in a 67-year-old patient who was admitted to Infectious Diseases Clinical Hospital No. 2 in Moscow in serious condition. The diagnosis of listeria meningoencephalitis was established on the basis of epidemiological, clinical, laboratory and instrumental data; when examining the cerebrospinal fluid using PCR, Listeria monocytogenes DNA was detected. Damage to the central nervous system with the development of meningoencephalitis was caused first by listeria, and then by the addition of secondary flora (Streptococcus species group G, detected by culture of cerebrospinal fluid). After the treatment, the patient was discharged in satisfactory condition with subsequent follow-up by an infectious disease specialist and a neurologist.

   Conclusion. The clinical case demonstrates the difficulties in diagnosis and draws the attention of practitioners to the need for caution against listeriosis in the differential diagnosis of meningitis and meningoencephalitis of various etiologies.

1. Bakulov I. A., Vasilyev D. A., Kovaleva N. E., Egorova I. Yu., Selyaninov Yu. O. Listeria and listeriosis: monograph. 2^nd ed., Ispr. Ulyanovsk: P. A. Stolypin UlGAU, 2016. 334 р. (In Russ.)

2. Labinskaya A. S., Kostyukova N. N., Ivanovoi S. M. Guide to medical microbiology. Private medical microbiology and etiological diagnosis of infections. Book 2. Moscow: Binom, 2015. 1152 p. (In Russ.)

3. Duranti A., Sabbatucci M., Blasi G., Acciari V. A., et al. A severe outbreak of listeriosis in central Italy with a rare pulsotype associated with processed pork products. J Med Microbiol. 2018; 67 (9): 1351-1360. DOI: 10.1099/jmm.0.000785.

4. Rodina L. V. Organization of epidemiological surveillance of listeriosis in the conditions of the city of Moscow : author. dis. Cand. honey. Sciences. M.: 2003. 20 p. (In Russ.)

5. Zaitseva E. A. System for the analysis of microbiological and molecular genetic markers for the detection of highly virulent strains of Listeria monocytogenes. Dis. Doc. honey. Sci. M., 2010. 27 p. (In Russ.)

6. Sozaeva L. G., Tetova V. B., Kuznetsov R. E., Samorukov V. Yu., Tumgoeva L. B., Mass E. E. Listeria meningitis in a patient at 33-34 weeks gestation. Multidisciplinary solution. Epidemiology and infectious diseases. 2018; 23 (1): 30-39. (In Russ.)

7. Ibragimova M. A. Modern aspects of listeria infection (literature review). 2016; 1: 84-91. (In Russ.)

8. Nagibina M. V., Vengerov Yu. Yа., Tishkevich O. A., Smirnova T. Yu., Baikova L. B., Svistunova T. S., Ryzhov G. E., Matosova S. V., Tsvetkova N. A., Sadykova V. D. Listeriosis of the central nervous system. Therapeutic archive. 2019; 11: 43-49. (In Russ.)

9. Karneeva Zh. N., Simonova O. I. Listeriosis. Journal for continuing medical education of doctors. Infectious diseases: news, opinions, training. 2016; 4: 69-72. (In Russ.)

10. Ermak T. N., Kozhevnikova G. M. Listeria: role in human infectious pathology and laboratory diagnostics : review Epidemiology and infectious diseases. Modern Medical Journal. 2003; (5): 64. (In Russ.)