Meningitis prouzrokovan bakterijom Listeria monocytogenes kod imunokompetentnog 18-godišnjeg bolesnika kao moguć dijagnostički i terapijski problem

  • Miodrag Živojin Vrbić Clinic for Infectious Diseases, Clinical Centre Niš, Niš, Serbia
  • Marina Dinić Institute of Public Health, Niš, Serbia
  • Maja Jovanović Clinic for Infectious Diseases, Clinical Centre Niš, Niš, Serbia
  • Aleksandar Ranković Clinic for Infectious Diseases, Clinical Centre Niš, Niš, Serbia
  • Lidija Popović - Dragonjić Clinic for Infectious Diseases, Clinical Centre Niš, Niš, Serbia
  • Marina Đorđević - Spasić Clinic for Infectious Diseases, Clinical Centre Niš, Niš, Serbia
DOI: https://doi.org/10.2298/1451
Ključne reči: meningitis||, ||meningitis, listeria monocytogenes||, ||listeria monocytogenes, diagnosis||, ||dijagnoza, therapeutics||, ||lečenje, anti-bacterial agents||, ||antibiotici,

Sažetak


Uvod. Listeria monocytogenes je treći najčešći uzročnik bakterijskih meningitisa kod odraslih. Obično pogađa osobe sa poremećajem ćelijski posredovanog imuniteta ili u odmaklom životnom dobu. Opisano je samo nekoliko bolesnika bez postojeće predispozicije. Prikaz bolesnika. U radu je prikazan osamnaestogodišnji, prethodno zdrav bolesnik, sa tipičnom kliničkom slikom meningitisa. Na osnovu ambulantnog lečenja ceftriaksonom i nalaza u cerebrospinalnoj tečnosti postavljena je pretpostavka o parcijalno lečenom bakterijskom meningitisu. Terapija, započeta vankomicinom i ceftriaksonom, koji je 4. dana zamenjen meropenemom, nije dala kliničko poboljšanje. Šestog dana od prijema iz cerebrospinalne tečnosti izolovana je Listeria monocytogenes, a primena ampicilina, mada odložena, dovela je do potpunog oporavka bolesnika. Zaključak. Kod mladih, imunokompetentnih osoba, uprkos prisutnim dijagnostičkim i terapijskim problemima, subakutni tok meningitisa prouzrokovanog bakterijom Listeria monocytogenes omogućava adekvatano lečenje i povoljan ishod bolesti.

 

 

Biografija autora

Miodrag Živojin Vrbić, Clinic for Infectious Diseases, Clinical Centre Niš, Niš, Serbia
Profesor, specijalista infektolog

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Objavljeno
2017/01/20
Broj časopisa
Vol. 70 Br. 10 (2013)
Rubrika
Prikaz bolesnika