Neurolisteriosis in a previously asymptomatic patient with serum IgM deficiency: a case report
- PDF / 523,695 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 65 Downloads / 183 Views
CASE REPORT
Open Access
Neurolisteriosis in a previously asymptomatic patient with serum IgM deficiency: a case report Kostas Patas1, Theodoros Mavridis2, Katerina Psarra3, Vassilis E. Papadopoulos2, Georgia Mandilara4, Alexandra Tsirogianni3, Sophia Vassilopoulou2 and Stylianos Chatzipanagiotou1,5*
Abstract Background: Listeria monocytogenes is an opportunistic pathogen of the central nervous system commonly associated with impaired cell-mediated immunity. We hereby present a case of adult neurolisteriosis where the only immunological feature persistently present was serum IgM deficiency, suggesting that non-specific humoral immunity may also play a central role in the control of neuroinvasion by Listeria monocytogenes. Case presentation: A 62-year-old male who had never experienced severe infections presented with headache, nuchal rigidity and confusion. Neuroimaging was normal and lumbar puncture revealed pleiocytosis (760 leukocytes/mm3) and hypoglycorrhachia (34 mg/dL). The patient was treated empirically for bacterial meningitis. Indeed, further analysis of the CSF showed infection by Listeria monocytogenes, which was accompanied by reduced serum IgM levels that persisted well beyond the period of acute bacterial infection. Levels of IgG and IgA isotypes, along with peripheral blood counts of major leukocyte subsets, were at the same time largely preserved. Intriguingly, the absence of membrane-bound IgM on B cells was essentially complete in the acute post-infection period leading to a remarkable recovery after 12 months, suggesting that mechanisms other than defective membrane expression are underlying serum deficiency. Conclusions: As far as we know, this is the first reported case of neurolisteriosis associated with IgM deficiency in an adult individual without a history of severe infections or other underlying conditions. A possible role of circulating IgM against invasive disease caused by Listeria monocytogenes, particularly in the early course of hostpathogen interaction, is discussed. Keywords: Neurolisteriosis, Listeria monocytogenes, IgM deficiency
* Correspondence: [email protected] 1 Department of Medical Biopathology, Eginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece 5 Department of Clinical Microbiology and Medical Biopathology, National and Kapodistrian University of Athens, Aeginition Hospital, Ave. Vassilissis Sophias 72-74, 115 28 Athens, Greece Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credi
Data Loading...
