Mustafa Serhat ŞAHİNOĞLU, Derya TÜMER, Selcen ÖZER KÖKKIZIL, Sevil SAPMAZ KARABAĞ, Sevil ALKAN

İmmünsüprese Hastada Akut Hidrosefali ile Komplike Listeria Monocytogenes Menenjiti Olgusu

Listeria monocytogenes menenjiti, yaşlı veya bağışıklığı baskılanmış hastalarda görülür ve yüksek mortaliteye neden olabilir. Hidrosefali, Listeria monocytogenes meningoensefalitin ciddi bir komplikasyonudur. Uygunsuz ampirik antimikrobiyal tedavi ve hidrosefali gelişimi, mortalite ile ilişkili ana bağımsız prognostik faktörlerdir. L.monocytogenes, özellikle bağışıklığı baskılanmış hastalarda menenjit ve bakteriyemi etkeni olabilir. Listeria monocytogenes’in akut hidrosefali ve yüksek mortaliteye sebep olabileceği unutulmamalıdır. Olgumuz; 58 yaşında kadın hastaydı ve otoimmün hepatit tanısı ile steroid kullanmaktaydı. İki gündür bilinç bulanıklığı ve ateş şikayeti ile hastaneye başvurdu. Akut hidrosefali ile komplike olan L. monocytogenes’e bağlı menenjit tanısıyla yoğun bakımda izlemi yapıldı. Hasta yoğun bakım takibinin 21. gününde ve mekanik ventilatör desteğinin 16. gününde kaybedildi. L.monocytogenes, özellikle immünosupresif hastalarda menenjit ve bakteriyemi etkeni olabilir. Yaşlı veya bağışıklığı baskılanmış hastalarda Listeria akılda tutulmalı ve Listeria için etkin ampirik tedavilere başlanmalıdır. Tedaviye rağmen klinik kötüleşen hastalarda akut hidrosefali akılda tutulmalıdır.

Anahtar Kelimeler:

hidrosefali, Listeria Monocytogenes, Menenjit

A case of Listeria monocytogenes Meningitis Complicated with Acute Hydrocephalus in an Immunosuppressed Patient

Listeria monocytogenes meningitis is seen in elderly or immunosuppressed patients and may cause high mortality. Hydrocephalus is a serious complication of Listeria monocytogenes meningoencephalitis. Inappropriate empirical antimicrobial therapy and the development of hydrocephalus are the main independent prognostic factors associated with mortality. L.monocytogenes may be a causative agent of meningitis and bacteremia, especially in immunosuppressed patients. It may cause acute hydrocephalus and should be considered because of its high mortality risk. The presented case is a 58-year-old female patient, who was using steroids, with a diagnosis of autoimmune hepatitis, and was admitted to the hospital with blurred consciousness and fever for two days. She was diagnosed with meningitis due to L. monocytogenes, which was complicated by acute hydrocephalus. The patient died on the 21st day of intensive care follow-up and the 16th day of mechanical ventilator support. L.monocytogenes may be a causative agent of meningitis and bacteremia, especially in immunosuppressive patients. Listeria should be kept in mind in elderly or immunosuppressed patients, and effective empirical treatments for Listeria should be started. Acute hydrocephalus should be kept in mind in patients with clinical worsening despite treatment.

Keywords:

Hydrocephalus, Listeria monocytogenes, Meningitis,

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