Case Report


Listeria monocytogenes septicemia and meningitis induced from immunosuppressant treatments in a patient with neuromyelitis optica spectrum disorder: A case report

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1 Attending physician, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China

2 Associate chief physician, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China

3 Chief physician, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China

Address correspondence to:

Kai Wang

Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province,

China

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Article ID: 101305Z01YH2022

doi: 10.5348/101305Z01YH2022CR

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How to cite this article

Hu Y, Wei L, Chen X, Jiang Y, Xie C, Wang K. Listeria monocytogenes septicemia and meningitis induced from immunosuppressant treatments in a patient with neuromyelitis optica spectrum disorder: A case report. Int J Case Rep Images 2022;13:101305Z01YH2022.

ABSTRACT


Introduction: The aim of this study is to report a fatal case of Listeria monocytogenes septicemia and meningitis complicating azathioprine and glucocorticosteroid treatments during an acute flare of neuromyelitis optica spectrum disorder (NMOSD).

Case Report: A Chinese woman who was diagnosed with NMOSD had been on oral prednisolone and azathioprine for about three years. After her fourth relapse, she was treated with high-dose glucocorticosteroids again, and she soon developed an impaired consciousness, headache, and neck stiffness. Her blood culture was positive for L. monocytogenes, and a head computed tomography showed severe hydrocephalus. Although shunt surgery was performed and antibiotics were used, the patient continued to decline and eventually died.

Conclusion: We reported the first Asian case of azathioprine-associated L. monocytogenes septicemia in a patient with NMOSD. Physicians should be aware of this serious and potentially lethal side effect when adding multiple immunosuppressants to the regimen of a patient who is already immunocompromised.

Keywords: Azathioprine, Listeria monocytogenes, Meningitis, Neuromyelitis optica

SUPPORTING INFORMATION


Author Contributions

Ying Hu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Ling Wei - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published

Xingui Chen - Revising it critically for important intellectual content, Final approval of the version to be published

Yubao Jiang - Revising it critically for important intellectual content, Final approval of the version to be published

Chengjuan Xie - Revising it critically for important intellectual content, Final approval of the version to be published

Kai Wang - Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2022 Ying Hu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.