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ISSN 2683-1678 (Print)
Órgano Oficial de la Sociedad
Latinoamericana de lnfectología Pediátrica.
Órgano de la Asociación Mexicana de
Infectología Pediátrica, A.C.
Órgano difusor de la Sociedad Española
de lnfectología

2021, Number 3

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Rev Latin Infect Pediatr 2021; 34 (3)

Listeria monocytogenes neuroinfection in a pediatric patient with newly diagnosed acute lymphoblastic leukemia. The relevance of early diagnosis

Valderrama CA, Navarro PN, Lopera MJ, Castañeda CL

Language: Spanish
References: 11
Page: 142-147
PDF size: 247.98 Kb.


ABSTRACT

Severe infection by Listeria monocytogenes in immunocompetent patients is uncommon; in pediatrics it becomes relevant during the neonatal stage and in immunocompromised patients. Its manifestations in the central nervous system (CNS) are encephalopathy, meningeal symptoms, abscesses or rhombencephalitis. In the majority of cases, the outcome entails a high morbidity and mortality if a timely diagnosis is not made. The case of a school-aged female patient is presented. She had been newly diagnosed with high-risk B precursor acute lymphoblastic leukemia, and presented with febrile neutropenia in the context of induction chemotherapy, she subsequently developed focal seizures that rapidly progressed to status epilepticus requiring third-line management (induced coma). Brain magnetic resonance imaging (MRI) demonstrated areas of left upper frontal parenchymal enhancement, involvement of the posterior arm of the right internal capsule and ipsilateral thalamic lesion, suspicious of abscess. The institution had molecular tests for multiple meningeal pathogens (FilmArray® Biomerieux), one of which was positive for L. monocytogenes, this determined early targeted treatment with high-dose ampicillin, with favorable clinical evolution. The most important aspects of CNS infection by this pathogen are discussed: epidemiological, pathophysiological, imaging and therapeutic, in order to serve as a guide for cases with similar characteristics.


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