Listeria monocytogenesin etken olduğu bir menenjit ve bakteriyemi olgusu
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Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Listeria monocytogenes genelde zoonotik inf eksiyon etkenidir. Yaşlı ve bağışıklık sistemi baskılanmış hastalarda önemli bir patojen olup, sağlıklı kişilerde çok nadir görülmektedir. Foliküler lenf oma ve kronik böbrek yetmezliği tanısı ile takip edilen 61 yaşındaki kadın hasta bilinç değişikliği ve ateş nedeniyle hastaneye yatırılmıştır. Hastanın fizik muayenesinde meninjiyal irritasyon bulguları saptanmıştır. Yapılan lomber ponksiyonda, beyin omurilik sıvısının (BOS) bulanık olduğu gözlenmiştir. BOS yaymasında, polimorfonükleer lökosit hakimiyeti olan bol lökosit görülmüş, mikroorganizma görülmemiştir. Hastanın hastaneye yatışından dört gün sonra kan ve BOS kültürlerinin her ikisinde de katalaz pozitif , oksidaz negatif, kokobasil görünümünde gram pozitif bakteri üremesi olmuştur. İzolatlar konvansiyonel yöntemlerle ve otomatize sistem ile L.monocytogenes olarak tanımlanmış ve disk difüzyon metodu ile yapılan duyarlılık çalışmasında, çalışılan tüm antibiyotiklere duyarlı oldukları gözlenmiştir. Ampirik olarak başlanan meropenem tedavisi, bakterinin duyarlı olduğu ampisilin ile değiştirilmiştir. Tekrarlanan kültürlerde üreme olmayan hasta şifa ile taburcu edilmiştir. L.monocytogenesin, özellikle immün sistemi baskılanmış hastalarda menenjit ve bakteriyemi etkeni olabileceğinin akılda tutulması gerekliliğinin vurgulanması amacıyla bu olgu sunulmuştur.
Listeria monocytogenes is generally a zoonotic inf ectious agent. Being an important pathogen in elderly and immuno-compromised patients, and rarely seen in healthy people. A sixty one year old f emale patient who was diagnosed with f ollicular lymphoma and chronic renal failure is hospitalized with symptoms such as change in consciousness and f ever. In the patients physical examination, findings of meningeal irritation were observed. The appearance of cerebrospinal fluid obtained via lomber punction was cloudy. Direct microscopical examination of CSF showed pleocytosis with predominance of polymorphonuclear leukocytes, however no microorganism was observed. Four days af ter hospitalization, oxidase negative and gram positive bacterial growth was observed in both blood and CSF cultures. The isolates were identif ied as L.monocytogenes by conventional methods and an automated identif ication system and the isolates were susceptible to all tested antibiotic by using disk diff usion method. The empirical treatment with meropenem was changed to ampicillin. No microbial growth was observed in control cultures and the patient was discharged uneventf ully. This case was presented to emphasize the necessity of keeping L.monocytogenes in mind as a rare cause of meningitis and bacteremia especially in nonimmunocompetent patients.
Listeria monocytogenes is generally a zoonotic inf ectious agent. Being an important pathogen in elderly and immuno-compromised patients, and rarely seen in healthy people. A sixty one year old f emale patient who was diagnosed with f ollicular lymphoma and chronic renal failure is hospitalized with symptoms such as change in consciousness and f ever. In the patients physical examination, findings of meningeal irritation were observed. The appearance of cerebrospinal fluid obtained via lomber punction was cloudy. Direct microscopical examination of CSF showed pleocytosis with predominance of polymorphonuclear leukocytes, however no microorganism was observed. Four days af ter hospitalization, oxidase negative and gram positive bacterial growth was observed in both blood and CSF cultures. The isolates were identif ied as L.monocytogenes by conventional methods and an automated identif ication system and the isolates were susceptible to all tested antibiotic by using disk diff usion method. The empirical treatment with meropenem was changed to ampicillin. No microbial growth was observed in control cultures and the patient was discharged uneventf ully. This case was presented to emphasize the necessity of keeping L.monocytogenes in mind as a rare cause of meningitis and bacteremia especially in nonimmunocompetent patients.
Açıklama
Anahtar Kelimeler
Bakteriyemi, Listeria monocytogenes, Menenjit, Bacteremia, Meningitis
Kaynak
ANKEM Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
28
Sayı
3
Künye
Doğan, M., Esenkaya Taşbent, F., Feyzioğlu, B., Baykan, M. (2014). Listeria monocytogenesin etken olduğu bir menenjit ve bakteriyemi olgusu. Ankem Dergisi, 28, 3, 114-118.
