Listeria monocytogenes Infections in Patients with AIDS: Report of Five Cases and Review

Five patients with AIDS and Listeria monocytogenes infection (three cases of bacteremia and two of meningitis) are reviewed. Four patients had prior or concurrent gastrointestinal illness. Two patients received corticosteroids. A 7- to 21-day course of ampicillin was administered with or without a 7...

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Bibliographic Details
Published in:Reviews of infectious diseases 1991-05, Vol.13 (3), p.413-417
Main Authors: Catherine F. Decker, Gary L. Simon, DiGioia, Richard A., Tuazon, Carmelita U.
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Adult
AIDS
AIDS/HIV
Ampicillin - therapeutic use
Bacteremia
Biological and medical sciences
Blood
Clinical Infectious Disease Articles
Diarrhea
Gentamicins - therapeutic use
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Listeria
Listeria meningitis
Listeria monocytogenes
Listeriosis - complications
Listeriosis - drug therapy
Macrophages
Male
Medical sciences
Meningitis, Listeria - complications
Meningitis, Listeria - drug therapy
Relapse
Sepsis - complications
Sepsis - drug therapy
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Summary:Five patients with AIDS and Listeria monocytogenes infection (three cases of bacteremia and two of meningitis) are reviewed. Four patients had prior or concurrent gastrointestinal illness. Two patients received corticosteroids. A 7- to 21-day course of ampicillin was administered with or without a 7- to 14-day course of gentamicin. This regimen was effective, with no evidence of relapse 7-8 months after therapy was discontinued. The relative infrequency of infection with L. monocytogenes in AIDS patients is unexpected. Tumor necrosis factor (TNF) appears to be essential in the inhibition of Listeria in vivo. Elevated levels of TNF in AIDS patients may be protective against listeriosis and thus help explain the low prevalence of listerial infection in this population. Nonetheless, although L. monocytogenes is an uncommon cause of illness in patients infected with the human immunodeficiency virus, it cannot be dismissed as a cause of undefined meningitis or sepsis.
ISSN:0162-0886