Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Brasileiro de Nefrologia |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000300375 |
Resumo: | Abstract Introduction: Infectious complications are common in systemic lupus erythematosus. Although uncommon, central nervous system infections do occur and have significant lethality, with several etiological agents. Methods: We report on the case of a 29-year-old woman recently diagnosed with systemic lupus erythematosus with hematological, cutaneous, serous and renal manifestations (class IV lupus nephritis), who underwent corticosteroid pulse therapy and mycophenolate induction therapy. After 3 months of evolution, she developed headache and altered mental status. Computed tomography showed an area of hypoattenuation in the left frontal white matter and her cerebrospinal fluid examination showed pleocytosis and hyperproteinorrhachia. Peripheral blood and CSF culture identified Listeria monocytogenes. The patient presented deterioration of her neurological status, requiring invasive mechanical ventilation, monitoring of intracranial pressure and, despite all the intensive support, persisted in a comatose state and developed multiple organ failure, evolving to death due to nosocomial bloodstream infection. Discussion: Infection from L. monocytogenes usually occurs after eating contaminated food, manifesting itself with diarrhea and, occasionally, invasively, such as neurolisteriosis. Further investigation with CSF analysis and MRI is necessary, and the diagnosis consists of isolating the bacteria in sterile body fluid. Conclusion: The case presents a patient whose diagnosis of meningoencephalitis became an important differential with neuropsychiatric disorder. The poor outcome reinforces the need to remember this infectious condition as a serious complication in the natural history of SLE. |
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Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus ErythematosusListeria monocytogenesMeningitisLupus Erythematosus, SystemicsAbstract Introduction: Infectious complications are common in systemic lupus erythematosus. Although uncommon, central nervous system infections do occur and have significant lethality, with several etiological agents. Methods: We report on the case of a 29-year-old woman recently diagnosed with systemic lupus erythematosus with hematological, cutaneous, serous and renal manifestations (class IV lupus nephritis), who underwent corticosteroid pulse therapy and mycophenolate induction therapy. After 3 months of evolution, she developed headache and altered mental status. Computed tomography showed an area of hypoattenuation in the left frontal white matter and her cerebrospinal fluid examination showed pleocytosis and hyperproteinorrhachia. Peripheral blood and CSF culture identified Listeria monocytogenes. The patient presented deterioration of her neurological status, requiring invasive mechanical ventilation, monitoring of intracranial pressure and, despite all the intensive support, persisted in a comatose state and developed multiple organ failure, evolving to death due to nosocomial bloodstream infection. Discussion: Infection from L. monocytogenes usually occurs after eating contaminated food, manifesting itself with diarrhea and, occasionally, invasively, such as neurolisteriosis. Further investigation with CSF analysis and MRI is necessary, and the diagnosis consists of isolating the bacteria in sterile body fluid. Conclusion: The case presents a patient whose diagnosis of meningoencephalitis became an important differential with neuropsychiatric disorder. The poor outcome reinforces the need to remember this infectious condition as a serious complication in the natural history of SLE.Sociedade Brasileira de Nefrologia2020-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000300375Brazilian Journal of Nephrology v.42 n.3 2020reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2019-0212info:eu-repo/semantics/openAccessPereira,Maria Eduarda Vilanova da CostaGonzalez,Diego EnnesRoberto,Fernanda BadianiForesto,Renato DemarchiKirsztajn,Gianna MastroianniDurão Júnior,Marcelino de Souzaeng2020-11-20T00:00:00Zoai:scielo:S0101-28002020000300375Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2020-11-20T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false |
dc.title.none.fl_str_mv |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
title |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
spellingShingle |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus Pereira,Maria Eduarda Vilanova da Costa Listeria monocytogenes Meningitis Lupus Erythematosus, Systemics |
title_short |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
title_full |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
title_fullStr |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
title_full_unstemmed |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
title_sort |
Listeria monocytogenes meningoencephalitis in a patient with Systemic Lupus Erythematosus |
author |
Pereira,Maria Eduarda Vilanova da Costa |
author_facet |
Pereira,Maria Eduarda Vilanova da Costa Gonzalez,Diego Ennes Roberto,Fernanda Badiani Foresto,Renato Demarchi Kirsztajn,Gianna Mastroianni Durão Júnior,Marcelino de Souza |
author_role |
author |
author2 |
Gonzalez,Diego Ennes Roberto,Fernanda Badiani Foresto,Renato Demarchi Kirsztajn,Gianna Mastroianni Durão Júnior,Marcelino de Souza |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Pereira,Maria Eduarda Vilanova da Costa Gonzalez,Diego Ennes Roberto,Fernanda Badiani Foresto,Renato Demarchi Kirsztajn,Gianna Mastroianni Durão Júnior,Marcelino de Souza |
dc.subject.por.fl_str_mv |
Listeria monocytogenes Meningitis Lupus Erythematosus, Systemics |
topic |
Listeria monocytogenes Meningitis Lupus Erythematosus, Systemics |
description |
Abstract Introduction: Infectious complications are common in systemic lupus erythematosus. Although uncommon, central nervous system infections do occur and have significant lethality, with several etiological agents. Methods: We report on the case of a 29-year-old woman recently diagnosed with systemic lupus erythematosus with hematological, cutaneous, serous and renal manifestations (class IV lupus nephritis), who underwent corticosteroid pulse therapy and mycophenolate induction therapy. After 3 months of evolution, she developed headache and altered mental status. Computed tomography showed an area of hypoattenuation in the left frontal white matter and her cerebrospinal fluid examination showed pleocytosis and hyperproteinorrhachia. Peripheral blood and CSF culture identified Listeria monocytogenes. The patient presented deterioration of her neurological status, requiring invasive mechanical ventilation, monitoring of intracranial pressure and, despite all the intensive support, persisted in a comatose state and developed multiple organ failure, evolving to death due to nosocomial bloodstream infection. Discussion: Infection from L. monocytogenes usually occurs after eating contaminated food, manifesting itself with diarrhea and, occasionally, invasively, such as neurolisteriosis. Further investigation with CSF analysis and MRI is necessary, and the diagnosis consists of isolating the bacteria in sterile body fluid. Conclusion: The case presents a patient whose diagnosis of meningoencephalitis became an important differential with neuropsychiatric disorder. The poor outcome reinforces the need to remember this infectious condition as a serious complication in the natural history of SLE. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000300375 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000300375 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/2175-8239-jbn-2019-0212 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
dc.source.none.fl_str_mv |
Brazilian Journal of Nephrology v.42 n.3 2020 reponame:Jornal Brasileiro de Nefrologia instname:Sociedade Brasileira de Nefrologia (SBN) instacron:SBN |
instname_str |
Sociedade Brasileira de Nefrologia (SBN) |
instacron_str |
SBN |
institution |
SBN |
reponame_str |
Jornal Brasileiro de Nefrologia |
collection |
Jornal Brasileiro de Nefrologia |
repository.name.fl_str_mv |
Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN) |
repository.mail.fl_str_mv |
||jbn@sbn.org.br |
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1752122066156388352 |