Clinical characteristics and prognostic indicators in Listeria monocytogenes meningoencephalitis: A retrospective case series and literature review.

BACKGROUND

Listeria monocytogenes meningoencephalitis (LMM) is a rare but severe central nervous system (CNS) infection. This study aimed to characterize the clinical manifestations, diagnostic findings, treatment responses, and prognostic factors associated with LMM.

METHODS

We retrospectively analyzed the clinical data of 13 patients diagnosed with LMM at Xuzhou Medical University Affiliated Hospital between 2018 and 2023. An additional five cases were identified through a literature search in the China National Knowledge Infrastructure (CNKI) and Wanfang databases from 2019 to 2022. Clinical features, cerebrospinal fluid (CSF) and blood test results, imaging findings, treatments, and outcomes were summarized.

RESULTS

Among 18 patients (11 males, 7 females; mean age 51.6 ± 17.2 years), all had acute onset with fever (100%), headache (83.3%), and altered consciousness (77.8%). CSF analysis showed elevated pressure in 83.3%, increased leukocytes and protein in all cases, and variable glucose levels. LM was cultured from CSF in 10 patients and detected via metagenomic next-generation sequencing (mNGS) in 12. Imaging findings included hydrocephalus in 4 cases and meningeal enhancement in 2 cases. Full recovery was observed in 2 cases, improvement in 9, palliative care in 3, and death in 4. Early seizures and hydrocephalus were linked to worse outcomes.

CONCLUSION

Listeria monocytogenes meningoencephalitis is a rapidly progressive CNS infection with variable presentations and significant risk of poor outcomes. Early recognition, appropriate antimicrobial coverage, and timely diagnostic testing are essential to improving prognosis.

TRIAL REGISTRATION: Not applicable.