Listeria monocytogenes meningitis in three immunocompetent children and a review of the literature

Objective:To summarize the clinical characteristics and treatment outcome of 3 cases of Listeria monocytogenes(Lm)meningitis in immunocompetent children,improve clinicians'awareness of the disease.Methods:The clinical features and treatment of Lm meningitis in children admitted to Children's Hospital of Zhejiang University School of Medicine from January 2016 to May 2019 were analyzed retrospectively.We summarized related literatures,and compared the selection of antibiotics in children with Lm meningitis reported in cases.Results:All patients had fever,vomiting and other symptoms,CSF as purulent meningitis performance,Ampicillin is currently the first choice of treatment,while meropenem and Linezolid could be administered as alternative drugs for Lm meningitis.Conclusions:For children with meningitis,when the empirical antibiotics treatment fill,the possibility of Lm meningitis should be considered,and antibiotics that can effectively cover Lm should be adjusted in time.

Treatment failure in a patient infected with Listeria sepsis combined with latent meningitis:A case report

BACKGROUND Listeria is a food-borne disease,which is rarely prevalent in the normal population;it mostly occurs in pregnant women,newborns,immunodeficiency patients,and the elderly.The main manifestations of this disease in patients include sepsis,meningitis,etc,and the mortality rate remains high,although the onset of meningitis is relatively insidious.CASE SUMMARY A 75-year-old man presented with a fever for 1 wk and was admitted to the hospital for diagnosis and management of a lung infection.His condition improved after receiving anti-infective treatment for 2 wk.However,soon after he was discharged from the hospital,he developed fever again,and gradually developed various neurological symptoms,impaired consciousness,and stiff neck.Thereafter,through the cerebrospinal fluid metagenomic testing and blood culture,the patient was diagnosed with Listeria monocytogenes meningitis and sepsis.The patient died after being given active treatment,which included penicillin application and invasive respiratory support.CONCLUSION This case highlights the ultimate importance of early identification and timely application of the various sensitive antibiotics,such as penicillin,vancomycin,meropenem,etc.Therefore,for high-risk populations with unknown causes of fever,multiple blood cultures,timely cerebrospinal fluid examination,and metagenomic detection technology can assist in confirming the diagnosis quickly,thereby guiding the proper application of antibiotics and improving the prognosis.

Meningoencephalitis due to Listeria monocytogenes in a Young Immunocompetent Patient: Case Report with Literature Review

Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompetent individuals. We present the case of a young adult patient without immunocompromise, who developed meningoencephalitis due to L. monocytogenes;This case is exceptional, since it occurred in an individual outside the classic age group, in addition to not having risk factors, which is why it should be considered an atypical causal agent.

Infection with Listeria monocytogenes meningoencephalitis:A case report

BACKGROUND Listeria meningitis is an infectious disease of the central nervous system caused by Listeria monocytogenes.This bacterium is widely present in the natural environment and can be transmitted through channels such as food and water.Patients usually show symptoms such as fever,headache,and neck stiffness.In severe cases,coma,convulsions,or even death may occur.Traditional diagnostic methods,such as cerebrospinal fluid(CSF)culture and serological tests,have certain limitations.Although CSF culture is the“gold standard”for diagnosis,it is time-consuming and has a relatively low positivity rate.Serological detection may also result in false positive or false negative results.The emergence of metagenomic sequencing(mNGS)technology has led to a significant break-through in diagnosing Listeria meningitis,allowing quick and accurate detection of various pathogens in samples.CASE SUMMARY Here,we present the case of a previously healthy 64-year-old woman diagnosed with Listeria meningitis using mNGS.She was successfully treated with intravenous ampicillin and meropenem,without any complications.CONCLUSION Listeria meningitis must be considered,especially in patients who fail to show improvement with first-line antibiotic treatments.mNGS significantly reduces the diagnosis time,supporting timely treatment of patients.

Case Report: Bilateral Intra-Parenchymal Hematomas Caused by Ventricular Flood Complicating Neonatal Salmonella typhi Meningitis

Salmonella meningitis is an uncommon condition in neonates, and when it does occur, it is often linked to serious complications, such as subdural collections and abscesses. We present a case involving a 23-day-old neonate diagnosed with Salmonella meningitis, who developed complications including bilateral intra-parenchymal hematomas with ventricular involvement. The infant showed significant improvement following an extended course of systemic antibiotics and supportive care.

Early Nursing Intervention in Children with Viral Meningitis

Aim: To explore the effect of a WeChat peer education program in children with severe viral meningitis combined with respiratory failure. Design: Retrospective cohort study. Methods: Patients who had severe viral meningitis combined with respiratory failure, were admitted to the hospital from March 2017 to June 2018, and who received the WeChat-based nursing intervention were included. Patients who received routine nursing were used as controls. The family’s emotional state, self-care ability, and rehabilitation were analyzed. Results: There were 37 patients in the WeChat group (19 boys (51.3%) and 18 girls (48.7%);mean of 5.1 ± 2.4 years of age) and 37 controls (20 boys (54.1%) and 17 girls (45.9%);mean of 5.9 ± 2.4 years of age) (all P > 0.05). After nursing, improvements in the self-assessed anxiety score and self-assessed depression score were better in the WeChat group (anxiety: -29.2% vs. -20.3%, P = 0.015;depression: -25.2% vs. -15.4%, P = 0.009). After nursing, the improvements in the condition management ability scale and condition management difficulty scale scores were better in the WeChat group (ability: +80.5% vs. +44.4%. P = 0.001;difficulty: +58.4% vs. +37.8%, P = 0.003). After nursing, the improvement in the Fugl-Meyer score was better in the WeChat group (+138.0% vs. +53.0%, P Conclusion: Early nursing intervention combined with WeChat peer education can improve the emotional state of children with severe viral meningitis combined with respiratory failure and their caregivers. Impact: Viral meningitis is associated with a good prognosis, but central nervous system complications can be observed. Early intervention is the key to a good prognosis. Internet-based nursing and coaching can improve self-efficacy and care ability in patients with various conditions, as well as improve the emotional state of the children and their caregivers. The research might have an impact on any children’s hospital that deals with viral meningitis.

Predictors of cerebrospinal fluid GeneXpert MTB/RIF positivity in patients with tuberculous meningitis:A prospective cohort study

Objective:To identify the clinical,laboratory,and radiological markers that could predict a positive GeneXpert result in patients suspected of tuberculous meningitis.Methods:In this prospective,observational study,patients with tuberculous meningitis were systematically evaluated.Various clinical,laboratory[including cerebrospinal fluid(CSF)microscopy,culture,and GeneXpert],and neuroimaging factors were examined.All participants were administered anti-tuberculous treatment and corticosteroids.A six-month follow-up was done to evaluate the outcome.Results:Of the 116 patients studied,54(46.6%)tested positive for GeneXpert,while 62(53.4%)were negative.Third cranial nerve involvement(OR 3.71,95%CI 1.052-13.09,P=0.04)and the presence of basal exudates on neuroimaging(OR 5.22,95%CI 2.03-13.42,P=0.001)emerged as independent predictive factors for a positive GeneXpert result.A positive CSF GeneXpert result(P=0.002)and drug resistance(P=0.004)were significantly linked to adverse outcomes.Additionally,a high score on the Medical Research Council stageⅢ(OR 5.64,95%CI 1.18-26.87,P=0.03)and elevated CSF cell counts(OR 1.002,95%CI 1.00-1.001,P=0.03)were identified as independent predictors of poor prognosis.Conclusions:Third cranial nerve involvement and the presence of basal exudates were significant indicators of a positive GeneXpert result.MRC stageⅢdisability and elevated CSF cell counts predicted poor outcomes.

Numerical Analysis of Bacterial Meningitis Stochastic Delayed Epidemic Model through Computational Methods

Based on theWorld Health Organization(WHO),Meningitis is a severe infection of the meninges,the membranes covering the brain and spinal cord.It is a devastating disease and remains a significant public health challenge.This study investigates a bacterial meningitis model through deterministic and stochastic versions.Four-compartment population dynamics explain the concept,particularly the susceptible population,carrier,infected,and recovered.The model predicts the nonnegative equilibrium points and reproduction number,i.e.,the Meningitis-Free Equilibrium(MFE),and Meningitis-Existing Equilibrium(MEE).For the stochastic version of the existing deterministicmodel,the twomethodologies studied are transition probabilities and non-parametric perturbations.Also,positivity,boundedness,extinction,and disease persistence are studiedrigorouslywiththe helpofwell-known theorems.Standard and nonstandard techniques such as EulerMaruyama,stochastic Euler,stochastic Runge Kutta,and stochastic nonstandard finite difference in the sense of delay have been presented for computational analysis of the stochastic model.Unfortunately,standard methods fail to restore the biological properties of the model,so the stochastic nonstandard finite difference approximation is offered as an efficient,low-cost,and independent of time step size.In addition,the convergence,local,and global stability around the equilibria of the nonstandard computational method is studied by assuming the perturbation effect is zero.The simulations and comparison of the methods are presented to support the theoretical results and for the best visualization of results.

Endogenous Endophthalmitis as a Triggering Factor for Fatal Bacterial Meningitis Caused by Streptococcus pneumoniae: A Case Report

Endogenous endophthalmitis is a rare condition with a poor long-term visual prognosis and significant mortality, often associated with the hematogenous spread of intravitreal infections and subsequent disruption of the blood-ocular barrier. Its anatomical proximity to the central nervous system (CNS) poses a high risk of infection dissemination, although cases documented in the literature are rare, and endogenous endophthalmitis is typically described as secondary to neuroinfections. We report the case of an 82-year-old female patient with a history of hypertension who presented with fever, decreased visual acuity, severe headache, chemosis, and conjunctival injection. Endogenous endophthalmitis was diagnosed, and antimicrobial treatment was initiated alongside surgical intervention by the ophthalmology service. However, the patient’s condition worsened neurologically, and Streptococcus pneumoniae was identified in cerebrospinal fluid cultures. Despite intensive medical treatment, the patient’s clinical course was poor, leading to death.

Human herpesvirus 7 meningitis in an adolescent with normal immune function:A case report

BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting illnesses.However,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially meningitis.The pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely studied.Therefore,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the disease.CASE SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle aches.The patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or diarrhea.The patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally normal.The patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not improve.The patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical resistance.Ocular B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both eyes.Optical coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic disc.DNA virus monitoring results:HHV-7.We gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium supplementation.CONCLUSION This study reports a case of HHV-7 meningitis in an adolescent with normal immune function.Through comprehensive analysis of the clinical manifestations,laboratory tests,and treatment methods of the patient,it is found that early identification and antiviral treatment are essential for the outcome of the disease.This case suggests that despite normal immune function,adolescents may still suffer from herpes virus type 7 meningitis,so clinicians should be vigilant and take effective treatment measures in time.

Infantile bacterial meningitis combined with sepsis caused by Streptococcus gallolyticus subspecies pasteurianus:A case report

BACKGROUND Streptococcus gallolyticus subspecies pasteurianus(SGSP)is a rare pathogen responsible for infant sepsis and meningitis and is potentially overlooked because it is not included in routine group B streptococcal screenings.Hence,we present a case of SGSP-induced infant meningitis and sepsis,accompanied by bronchopneumonia induced by multidrug-resistant Staphylococcus aureus(MRSA),providing insights into the identification,management,and prognosis of this bacterial infection.CASE SUMMARY A 45-day-old female infant presented with two episodes of high fever(maximum temperature:39.5°C)and two generalized grand mal seizure episodes that lasted over ten seconds and self-resolved without concomitant symptoms.Postadmission,the patient’s C-reactive protein level was 40.73 mg/L,white blood cell count was 13.42×10^(9)/L,neutrophil ratio was 78.4%,procalcitonin level was 7.89μg/L,cerebrospinal fluid(CSF)white cell count was 36×10^(6)/L,multinucleated cell ratio was 95.2%,and protein concentration was 0.41 g/L.Blood and CSF culture revealed that the pathogen was SGSP.The bacterium was sensitive to ampicillin,furazolidone,penicillin,lincomycin,moxifloxacin,rifampicin,vancomycin,and levofloxacin but resistant to clindamycin and tetracycline.Sputum culture revealed the presence of MRSA,which was sensitive to vancomycin.The patient was diagnosed with meningitis and sepsis caused by SGSP,accompanied by bronchopneumonia induced by MRSA.Ceftriaxone(100 mg/kg/d)combined with vancomycin(10 mg/kg/dose,q6h)was given as an anti-infective treatment postadmission.After 12 days of treatment,the infant was discharged from the hospital with normal CSF,blood culture,and routine blood test results,and no complications,such as subdural effusion,were observed on cranial computed tomography.No growth retardation or neurological sequelae occurred during follow-up.CONCLUSION SGPSP-induced infant bacterial meningitis and sepsis should be treated with prompt blood and CSF cultures,and a sensitive antibiotic therapy to ensure a favorable prognosis.

A Rare Case of Aortic Valve Endocarditis and Acute Meningitis Due to Haemophilus influenzae

HACEK organisms represent a rare but important group of causative pathogens in endocarditis. These bacteria have historically been associated with culture-negative endocarditis;however, modern laboratory techniques have made this less common. In this case, we present a 74-year-old man who presented with acute onset altered mentation, fever, and sepsis. He was ultimately found to have Haemophilus influenzae meningitis, cerebral empyema, aortic valve endocarditis, psoas myositis, and L2 - L3 diskitis with osteomyelitis. Although HACEK organisms are commonly found in the oropharynx and upper respiratory tract in humans, our patient did not report recent preceding dental or ENT procedures. H. influenzae is responsible for approximately 0.16% of all cases of bacterial endocarditis, representing a very limited subset. Although generally considered low virulent pathogens, this case demonstrates the unusual extent of infection from a HACEK organism, H. influenzae, causing aortic valve endocarditis as well as atypical non-cardiac sequelae, including acute meningitis.

Role of lumbar puncture in clinical outcome of suspected acute bacterial meningitis

BACKGROUND Meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United States.Guidelines recommend obtaining blood cultures and cerebrospinal fluid(CSF)studies in patients presenting with acute meningitis syndrome,and beginning treatment with broad spectrum antibiotics based on the age and certain predisposing conditions.In some patients however,the diagnostic lumbar puncture(LP)is not performed due to a multitude of reasons,ranging from increased intracranial pressure to failed attempt.In such situations,appropriate therapy is initiated empirically and often continued without establishment of a definitive diagnosis.AIM To determine whether a diagnostic LP in acute meningitis syndrome was associated with a better outcome and less duration of antibiotic therapy,along with potential causes for deferral of procedure.METHODS A retrospective study was conducted amongst the patients presenting to a 360 bedded community hospital in central Massachusetts with a diagnosis of acute meningitis syndrome between January 2010-September 2022.The electronic health records were accessed to collect necessary demographic and clinical data,including etiology of meningitis,lumbar puncture results,reason for procedure deferral,duration of antibiotic therapy and clinical outcome.The patients were subsequently divided into two groups based on whether they received a LP or not,and data was analyzed.RESULTS A total of 169 patients admitted with acute meningitis syndrome between September 2010-2022 were included in the study.The mean age of the participants was 54.3 years(SD+/-19.2 years).LP was performed for 130(76.9%)participants,out of which,28(21.5%)showed some growth in CSF culture.The most commonly identified organism was streptococcus pneumoniae.Amongst the 39 patients in whom LP was deferred,the major reasons recorded were:Body habitus(n=6,15.4%),and unsuccessful attempt(n=4,10.3%).While 93(71.5%)patients with LP received antibiotic therapy,only 19(48.7%)patients without LP received the antibiotics,with the principal reason being spontaneous improvement in sensorium without any diagnosed source of infection.The mean duration of antibiotic use was 12.3 days(SD+/-5.6)in the LP group and 11.5 days(SD+/-7.0)in the non-LP group(P=0.56;statistically not significant).We observed higher long term sequalae in the non-LP group(n=6,15.4%)compared to the LP group(n=9,6.9%).Similarly,the death rate was higher in the non-LP group(n=7,18.0%)compared to the LP group(n=9,6.9%).CONCLUSION LP remains the cornerstone for diagnosing meningitis,but often CSF results are unavailable,leading to empiric treatment.Our study identified that body habitus and unsuccessful attempts were the most common reasons for LP not being performed,leading to empiric antibiotic coverage.There was no difference between the duration of antibiotics received by the two groups,but a lower proportion of patients without LP received antibiotics,attributed to a spontaneous improvement in sensorium.However,the residual neurological sequelae and death rates were higher in patients without LP,signifying a potential under-treatment.A LP remains crucial to diagnose meningitis,and a lack of CSF analysis predisposes to under-treatment,leading to higher neurological sequelae and increased chances of death.

Identified Bacteria and Virus in the Cerebrospinal Fluid of under Five Years Hospitalized Children for Clinical Meningitis at Panzi Hospital in the Eastern Part of DRC

Background: Meningitis remains a leading cause of death among children below 5 years of age in the Democratic Republic of the Congo (DR Congo). Distinguishing children with bacterial meningitis from those with viral meningitis in the emergency department is sometimes difficult. Here we identified bacteria and virus in the cerebral spinal fluid (CSF) of children with meningitis. Material and Methods: This is a prospective, analytical study carried out in the Pediatrics department of Panzi Hospital in the South-Kivu province of DR Congo. Between April 2021 and March 2022, 150 of 251 collected CSF from children aged from 1 to 59 months hospitalised due to clinical meningitis at Panzi referral university hospital, Bukavu, Eastern DR Congo were sent to the Lancet laboratory for bacteria identification by a multiplex real-time PCR assay for detection of the most different viruses and bacterial species causing meningitis. Result: The used multiplex real-time PCR assay allowed us to identify germs in 24.7% of cases (37/150). We isolated bacteria in 25/37 (67.5%) cases, and viruses in 9/37 (24.3%) while virus and bacteria co-infection was detected in 3/37 (8.1%). The most frequently identified bacteria were Streptococcus pneumoniae 14/37 (37.8%) followed by Haemophilus influenzae 6/37 (16.2%). The main virus was cytomegalovirus 5/37 (3.5%). Despite the age, the most found bacterial are common in children from rural areas and unvaccinated children. Bacterial and virus co-infection were identified in 66.7% of children aged between 25 - 60 months, mainly among male children, and in all children from rural areas (100%). The overall case fatality rate was 30% and was very high among cases with co-infection CMV-Pneumococcal (66.7%), followed by Streptococcus pneumoniae (50%). Conclusion: Meningitis remains frequent among children aged from one to 59 months among Bukavu Infants. We noticed that, Children with co-infection with bacteria and viruses might need higher attention when having meningitis symptoms, as this could lead to fatal outcomes. The introduction of molecular techniques, such as multiplex real-time PCR, has the potential to improve diagnosis and patient outcomes.

超高压联合月桂酰精氨酸乙酯盐酸盐对Listeria innocua的杀菌效果

单核细胞增生李斯特菌(以下简称单增李斯特菌)是导致李斯特菌病的食源性致病菌,对人类健康构成极大威胁,控制单增李斯特菌的生长对防治食物污染具有重要作用,Listeria innocua常作为单增李斯特菌的替代菌株进行实验研究。为了更好地保持食品的感官特性和营养成分并延长其保质期,本实验探究了超高压(high pressure processing,HPP)联合月桂酰精氨酸乙酯盐酸盐(lauroyl arginate ethyl ester hydrochloride,LAE)处理对L.innocua的杀菌效果及可能作用机制,并以火腿作为研究对象,探究HPP与LAE联合处理在实际食品体系中的应用可行性。结果表明,60 min内LAE即可对L.innocua产生较强的杀菌作用,其中,经12 mg/L的LAE作用60 min后,菌落数减少了3.12(lg(CFU/mL));在与压力的共同作用下,细胞皱缩、凹陷更为明显,且有细胞内容物被观察到,细胞膜通透性改变。350 MPa高压处理5 min协同12 mg/L LAE可以使L.innocua降低4.87(lg(CFU/mL)),分别比单独高压、单独LAE处理提高了3.25、3.54(lg(CFU/mL)),表现出协同杀菌作用。同时,两者在火腿中也表现出明显的协同杀菌作用,本研究结果可为控制即食肉制品中的食源性病原菌提供理论参考。

Varicella-zoster virus meningitis with hypoglycorrhachia: A case report

BACKGROUND Varicella-zoster virus(VZV)is a common viral infection,but meningitis is a rare complication of VZV infection.The cerebrospinal fluid glucose of viral meningitis is usually within the normal range,which is different from bacteria,fungi,and cancerous meningitis.This paper reports a case of VZV meningitis with hypoglycorrhachia and the relevant literature was reviewed.CASE SUMMARY We report a case of an immunocompetent 39-year-old male,presenting with severe headache and fevers,without meningeal signs or exanthem,found to have VZV meningitis by the metagenomic next-generation sequencing of cerebrospinal fluid.The cerebrospinal fluid analysis revealed hypoglycorrhachia(cerebrospinal fluid glucose of 2.16)and he was treated successfully with intravenous acyclovir.Our literature review identified only ten cases diagnosed with VZV meningitis with hypoglycorrhachia previously reported to date in the English literature whose cerebrospinal fluid glucose was from 1.6 to 2.7mmol/L,with a ratio of cerebrospinal fluid to serum glucose from 0.30 to 0.49.CONCLUSION Although rare,the cerebrospinal fluid of patients with VZV meningitis may have hypoglycorrhachia,which broadens the understanding of the disease.

In Hospital Death among under Five Years Children Hospitalized with Meningitis in the Eastern of the Democratic Republic of Congo

Background: Meningitis is a major public health problem needing timely diagnosis, appropriate treatment, prevention and control. Despite the advances in diagnosis and treatment of infectious diseases, meningitis is still considered as an important cause of mortality and morbidity, especially in the paediatric population of lower income countries such as the Democratic Republic of the Congo (DR Congo). In this study, we aimed to analyse the fatality aspect of suspected meningitis among children under five years. Materials and Methods: A prospective, descriptive study was carried out in the Paediatrics departments of four hospitals in the South-Kivu province in the Eastern part of the DR Congo from April 2021 to March 2022. Of the 1386 children enrolled, 251 children were suspected of meningitis. This study captures data generated in the framework of routine medical practice, which includes medical history, clinical diagnosis and results of locally conducted laboratory tests. Results: Throughout the study period, a total of 251 patients (18.1%) aged 1 month to 59 months with suspected meningitis were recruited out of 1386 children hospitalized in the Paediatrics. The fatality among hospitalized children with suspected meningitis during the study period was 27.9%, however the mortality linked to meningitis decreases with age, ranging from 37.5% among children under 2 years to 19.4% among those over 2 years old. Children hospitalized for meningitis with malnutrition as an underlying conditions, had a 3.5 times greater risk of dying. The case fatality rate was higher in transferred and not vaccinated children respectively (2.3 and 2.5 times). We observe that the death occurs early within the first 3 days. Conclusion: Our study noted a higher fatality rate in children with suspected meningitis that could probably be linked to the gape in vaccination and malnutrition as underline condition.

Meningitis Outbreak Caused by Neisseria meningitidis Serogroup C ST 10217 in 2019 in Diapaga, Burkina Faso

Introduction: Meningitis caused by Neisseria meningitidis constitutes a burden for the countries in the meningitis belt of sub-Saharan in general and particularly for Burkina Faso. In 2019 the Diapaga health district experienced a meningitis epidemic due to N. meningitidis serogroup C. Methods: This is a cross-sectional study with a descriptive aim in the health district of Diapaga where all cases of meningitis were included in this work. Rapid diagnostic tests (RDTs), culture as well as real-time PCR were used for the biological analysis of cerebral spinal fluid (CSF) samples. Results: Of 155 CSF samples analysed, 42% (65/155) were tested positve. Of them, N. meningitidis C accounted for 83% of all positive cases. Likewise, all thirteen (13) NmC strains were susceptible to oxacillin, ceftriaxone, penicillin and chloramphenicol. All strains of NmC belonged to the sequence type (ST) 10 217 and to the clonal complex (CC) 10 217. These CCs belonged to the same variant PorA type: P1.21-15.16;FetA type: F1-7;PorB type: 3-463. Conclusion: Burkina Faso had known an epidemic of meningitis caused by NmC in 2019 in the health district of Diapaga. This outbreak was contained in time due to the performance of the epidemiological surveillance system which made it possible to investigate on time and introduce the vaccine against the pathogen NmC.

Disseminated tuberculosis presenting as meningitis and spondylodiscitis in an immunocompetent adult

Rationale:Disseminated tuberculosis involves the central nervous system in up to a third of cases.However,meningitis and spondylodiscitis due to miliary tuberculosis rarely occur together,particularly in the immuno-competent population.Patient concerns:A 37-year-old immunocompetent male presented with altered level of consciousness for one week and lower back pain with evening pyrexia for one month.Examination revealed spastic paraplegia and left hemiparesis.Diagnosis:Disseminated tuberculosis presenting with meningitis and spondylodiscitis.Interventions:Category I anti-tuberculous therapy with a tapering regimen of intravenous dexamethasone was administered.Outcomes:There was clinical improvement after nine months of treatment.Lessons:Tuberculosis may present with atypical clinical manifestations.Contrast enhanced computed tomography scan or magnetic resonance imaging combined with histopathological features,a high index of suspicion and clinical improvement with anti-tuberculous treatment can confirm the diagnosis in the absence of microbiological evidence,especially in extrapulmonary tuberculosis.

Transcriptomics reveals substance biosynthesis and transport on membranes of Listeria monocytogenes affected by antimicrobial lipopeptide brevilaterin B

Listeria monocytogenes is a worrisome food-borne pathogen threatening global food safety.Our previous study proved that lipopeptide brevilaterin B showed efficient antibacterial activity against L.monocytogenes by interacting with the cell membrane.This research further explored the antibacterial mechanism of brevilaterin B against L.monocytogenes at the sub-minimum inhibition concentration via transcriptomic analysis.Brevilaterin B induced growth inhibition rather than direct membrane lysis in L.monocytogenes at the minimum inhibitory concentration.Transcriptomic analysis showed 1779 difference expressed genes,including 895 up-regulated and 884 down-regulated genes.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis indicated that brevilaterin B influenced multiple pathways of L.monocytogenes,including peptidoglycan biosynthesis,membrane transport(ATP-binding cassette transports,ion transport),cellular metabolism(amino acid and lipid metabolism),ATP synthesis,and activation of the stress response(quorum sensing and bacterial chemotaxis).In conclusion,brevilaterin B affects gene expression related to biosynthesis,transport and stress response pathways on the membrane of L.monocytogenes.The present work provides the first transcriptomic assessment of the antibacterial mechanism of lipopeptide brevilaterin B at the gene level.