PMID- 24902522
OWN - NLM
STAT- MEDLINE
DCOM- 20150520
LR  - 20211021
IS  - 1439-0973 (Electronic)
IS  - 0300-8126 (Linking)
VI  - 42
IP  - 5
DP  - 2014 Oct
TI  - Listeria monocytogenes meningoencephalitis in adults: analysis of factors related 
      to unfavourable outcome.
PG  - 817-27
LID - 10.1007/s15010-014-0636-y [doi]
AB  - PURPOSE: To analyse the short-term outcome in patients with Listeria 
      monocytogenes meningoencephalitis (LMME) to improve management and outcome. 
      METHODS: Observational study with adult patients with LMME between 1977 and 2009 
      at a tertiary hospital in Barcelona, Spain. Parameters that predicted outcome 
      were assessed with univariate and logistic regression analysis. RESULTS: Of 59 
      cases of LMME, 28 occurred in the last decade. Since 1987, a new protocol has 
      been used and 29/45 patients (64%) treated since then received adjuvant 
      dexamethasone. In patients who received this treatment there was a trend towards 
      fewer neurological sequelae (5 vs 33%; p = 0.052). Antiseizure prophylaxis with 
      phenytoin was administered in 13/45 (28%) patients. Seizures occurred in 7/45 
      (16%) patients, all in the group who did not receive phenytoin. Hydrocephalus 
      presented in 8/59 (14%). It was never present at admission and five patients 
      needed neurosurgical procedures. Sequelae after 3 months were present in 8/45 
      (18%), mostly cranial nerve palsy. Rhombencephalitis (RE) was related to the 
      presence of neurologic sequelae (OR: 20.4, 95% CI: 1.76-236). Overall mortality 
      was 14/59 (24%), 9/59 (15%) due to neurological causes related to hydrocephalus 
      or seizures. Mortality was defined as early in 36% and late in 64%. In the 
      multivariate analysis, independent risk factors for mortality were presence of 
      hydrocephalus (OR: 17.8, 95% CI: 2.753-114) and inappropriate empirical 
      antibiotic therapy (OR: 6.5, 95% CI: 1.201-35). CONCLUSIONS: Outcome of LMME may 
      be improved by appropriate empirical antibiotic therapy, suspicion and careful 
      management of hydrocephalus. Use of adjuvant dexamethasone or phenytoin in a 
      subgroup of these patients might have a benefit.
FAU - Pelegrin, I
AU  - Pelegrin I
AD  - Infectious Diseases Services, IDIBELL-Hospital Universitari de Bellvitge, Feixa 
      Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain, 
      ivan_pelegrin@hotmail.com.
FAU - Moragas, M
AU  - Moragas M
FAU - Suarez, C
AU  - Suarez C
FAU - Ribera, A
AU  - Ribera A
FAU - Verdaguer, R
AU  - Verdaguer R
FAU - Martinez-Yelamos, S
AU  - Martinez-Yelamos S
FAU - Rubio-Borrego, F
AU  - Rubio-Borrego F
FAU - Ariza, J
AU  - Ariza J
FAU - Viladrich, P F
AU  - Viladrich PF
FAU - Cabellos, C
AU  - Cabellos C
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140606
PL  - Germany
TA  - Infection
JT  - Infection
JID - 0365307
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Anticonvulsants)
RN  - 7S5I7G3JQL (Dexamethasone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Inflammatory Agents/*therapeutic use
MH  - *Antibiotic Prophylaxis
MH  - Anticonvulsants/*therapeutic use
MH  - Dexamethasone/*therapeutic use
MH  - Female
MH  - Humans
MH  - Hydrocephalus/*drug therapy/microbiology/mortality
MH  - Listeria monocytogenes/physiology
MH  - Male
MH  - Meningitis, Listeria/complications/*drug therapy/microbiology/mortality
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Risk Factors
MH  - Seizures/*drug therapy/microbiology/mortality
MH  - Spain/epidemiology
EDAT- 2014/06/07 06:00
MHDA- 2015/05/21 06:00
CRDT- 2014/06/07 06:00
PHST- 2013/12/30 00:00 [received]
PHST- 2014/05/19 00:00 [accepted]
PHST- 2014/06/07 06:00 [entrez]
PHST- 2014/06/07 06:00 [pubmed]
PHST- 2015/05/21 06:00 [medline]
AID - 10.1007/s15010-014-0636-y [doi]
PST - ppublish
SO  - Infection. 2014 Oct;42(5):817-27. doi: 10.1007/s15010-014-0636-y. Epub 2014 Jun 
      6.