Estudio clinicoepidemiolÓgico de la neurolisteriosis en la provincia de Segovia

Introduction. Listeria monocytogenes is a microorganism with marked tropism towards the central nervous system. One of the commonest forms of presentation is as a meningeal infection. The objective of this study is to describe the epidemiological, clinical and laboratory characteristics and therapeutic implications. Patients and methods. We made a retrospective analysis offourpatients, admitted to hospital with the diagnosis ofmeningeal infection and positive culture for L. monocytogenes in the cerebrospinal fluid (CSF), who were admitted to our centre between 1 January 1996 and 31 December 2000. The overall rate of meningitis due to L. monocytogenes in the province of Segovia is similar to that reported from the USA and Europe (six cases per million inhabitants per year). All the patients were male, aged between 19 and 79 years. The commonest form of presentation was a meningealsyndrome. Analysis of the CSF showed pleocytosis with high protein and low glucose levels. Gram stainingwas negative in all cases. Initial empirical treatment proved to be correct in two of the four patients. The only predisposing factors observed were alcoholism and diabetes mellitus. All four cases recovered. Conclusion. We emphasize the difficulty in diagnosing meningitis due to L. monocytogenes, since the presenting symptoms are relatively non-specific, CSF analysis gives variable results and Gram staining is of little use. Clinicalsuspicion is importantso that specific antibiotic treatment may be given to improve the prognosis.