VIÊM MÀNG NÃO DO LISTERIA MONOCYTOGENES Ở NGƯỜI BỆNH SUY GIẢM MIỄN DỊCH: BÁO CÁO CA BỆNH

Abstract

Determining the cause of meningitis is mainly by culture of cerebrospinal fluid, but it takes a long time. Our case detected Listeria monocytogenes in CSF by multi-agent Real-time PCR method, this is a rare case in young people, it has high diagnostic value as well as high reference. The patient, male, 31 years old, was admitted to Military Hospital 103 because of high fever, coma, defecation and urinary incontinence, many systemic purpura. Patients with a history of long-term treatment of Lupus erythematosus with corticosteroids have been stable, with no previous record of eating raw food or eating habits of undercooked vegetables. The patient had normal CT scan results at the time of admission and cranial MRI one day after admission, CSF depending on 3540 cells/mm3, Netrophils 80%, PCT 74.8 ng/mL. Multi-agent PCR after two days of treatment, blood culture after four days of treatment showed the same pathogen as Listeria monocytogenes. The patient was diagnosed: bacteremia with meningitis - meningoencephalitis caused by Listeria monocytogenes on the health background of systemic lupus erythematosus. Patients are successfully treated by accurately identifying the causative agent. Ampicillin and Gentamicin show good efficacy and proper treatment of the underlying cause contributes to good recovery and no sequelae.