Meningo-rhombencephalitis caused by Listeria monocytogenes in a healthy adult patient who consumes fresh dairy products: case report

Resumo

Introduction: Listeria monocytogenes is an opportunistic foodborne bacterium that can affect the central nervous system not only in immunosuppressed patients, but also in healthy individuals. For diagnostic suspicion, a complete medical history is essential, including not only the presence of diseases and the use of immunosuppressive drugs, but also dietary habits.

Objective: To remind that even in non-immunosuppressed patients, Listeria monocytogenes can affect the central nervous system, and to warn of the risk of human contamination through the consumption of fresh dairy products and the importance of medical history.

Methods: Descriptive, retrospective, observational and analytical case report study using information obtained from the patient and physical medical records.

Case description: Male patient, 43 years old, farmer, healthy, who ingested unpasteurized milk and raw cheese, presented with initial symptoms of bacterial meningitis, and despite empirical antibiotic therapy, he developed signs of rhombencephalitis and obstructive hydrocephalus, requiring external ventricular drainage (EVD). With the identification of Listeria monocytogenes in the cerebrospinal fluid, it was possible to change the antibiotic to ampicillin, and the patient began to show favorable progress, becoming asymptomatic.

Conclusion: Although rare in non-immunosuppressed patients and lacking a typical presentation, neurolisteriosis should be included in the differential diagnosis of patients with central nervous system infection, especially those involved in the production and/or consumption of dairy products. Cultural tests are essential for identifying the bacterium, and early use of specific antibiotics is crucial for reducing morbidity and mortality rates associated with this disease.