Rapid CSF Molecular Diagnosis of Listeria monocytogenes Meningoencephalitis in an Elderly Immunocompetent Patient: A Case Report.
- 1Department of Infectious Diseases, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.
- 21st Infectious Disease Clinic, Mureș County Clinical Hospital, 540233 Târgu Mureș, Romania.
- 3Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.
Abstract
Background/Objectives: Listeria monocytogenes is an uncommon but potentially life-threatening cause of central nervous system infection, predominantly affecting older adults and immunocompromised patients. Neurolisteriosis may present with nonspecific neurological manifestations, and the absence of classical meningeal signs may delay diagnosis. We report a case of L. monocytogenes meningoencephalitis in an elderly patient without known immunosuppression, with rapid cerebrospinal fluid (CSF) molecular testing facilitating early diagnosis and appropriate antimicrobial treatment. Case presentation: A 76-year-old man with significant cardiovascular comorbidities was admitted with a 3-day history of fever, headache, nausea, vomiting, fatigue, and gait instability. He was alert on admission, with only mild meningeal signs, and initial cranial computed tomography showed no acute intracranial abnormalities. CSF analysis revealed inflammatory changes. Empirical ceftriaxone therapy was supplemented with vancomycin, followed by the initiation of intravenous ampicillin and gentamicin after molecular identification of L. monocytogenes. The diagnosis was subsequently confirmed by CSF culture, while blood cultures remained negative. Clinical and laboratory parameters improved progressively, accompanied by marked improvement in CSF findings on follow-up examination. The patient was discharged in stable condition after 18 days of hospitalization. Conclusions: Neurolisteriosis should be considered in elderly patients presenting with fever and neurological symptoms, even in the absence of overt immunosuppression or prominent meningeal signs. This case highlights the diagnostic value of rapid CSF molecular testing, particularly when blood cultures are negative and the initial clinical presentation is nonspecific. Early recognition of L. monocytogenes infection and timely initiation of targeted antimicrobial therapy are essential to improving outcomes.
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BibTeX
@article{andrejkovits2026rapid,
title = {{Rapid CSF Molecular Diagnosis of Listeria monocytogenes Meningoencephalitis in an Elderly Immunocompetent Patient: A Case Report.}},
author = {Ákos Vince Andrejkovits and Róbert Ladó and Adrian Vlad Pop and Răzvan Lucian Coșeriu and Camelia Vintilă and Adrian Man and Anca Meda Văsieșiu and Elena Cristina Gîrbovan},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/diagnostics16193162},
url = {https://europepmc.org/article/MED/42882317},
note = {CC BY},
}
RIS
TY - JOUR
TI - Rapid CSF Molecular Diagnosis of Listeria monocytogenes Meningoencephalitis in an Elderly Immunocompetent Patient: A Case Report.
AU - Ákos Vince Andrejkovits
AU - Róbert Ladó
AU - Adrian Vlad Pop
AU - Răzvan Lucian Coșeriu
AU - Camelia Vintilă
AU - Adrian Man
AU - Anca Meda Văsieșiu
AU - Elena Cristina Gîrbovan
PY - 2026
DA - 2026/09/29
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193162
UR - https://europepmc.org/article/MED/42882317
AB - Background/Objectives: Listeria monocytogenes is an uncommon but potentially life-threatening cause of central nervous system infection, predominantly affecting older adults and immunocompromised patients. Neurolisteriosis may present with nonspecific neurological manifestations, and the absence of classical meningeal signs may delay diagnosis. We report a case of L. monocytogenes meningoencephalitis in an elderly patient without known immunosuppression, with rapid cerebrospinal fluid (CSF) molecular testing facilitating early diagnosis and appropriate antimicrobial treatment. Case presentation: A 76-year-old man with significant cardiovascular comorbidities was admitted with a 3-day history of fever, headache, nausea, vomiting, fatigue, and gait instability. He was alert on admission, with only mild meningeal signs, and initial cranial computed tomography showed no acute intracranial abnormalities. CSF analysis revealed inflammatory changes. Empirical ceftriaxone therapy was supplemented with vancomycin, followed by the initiation of intravenous ampicillin and gentamicin after molecular identification of L. monocytogenes. The diagnosis was subsequently confirmed by CSF culture, while blood cultures remained negative. Clinical and laboratory parameters improved progressively, accompanied by marked improvement in CSF findings on follow-up examination. The patient was discharged in stable condition after 18 days of hospitalization. Conclusions: Neurolisteriosis should be considered in elderly patients presenting with fever and neurological symptoms, even in the absence of overt immunosuppression or prominent meningeal signs. This case highlights the diagnostic value of rapid CSF molecular testing, particularly when blood cultures are negative and the initial clinical presentation is nonspecific. Early recognition of L. monocytogenes infection and timely initiation of targeted antimicrobial therapy are essential to improving outcomes.
SN - 2075-4418
ER -