Introduction. Listeria monocytogenes is the third most frequent cause of bacterial meningitis in adults. It commonly affects persons with defective cell-mediated immunity or advanced age, and only a few patiens with no underlying predisposition have been reported. Case report. We presented an previously healthy, 18-year-old man with typical clinical features of meningitis. On the account of earlier treatment with ceftriaxone and cerebrospinal fluid finding, an assumption of partially treated

more »

... terial meningitis was made. The initial treatment with vancomycin and ceftriaxone, substituted on day 4 with meropenem, did not produce any clinical effect. On day 6 Listeria monocytogenes was isolated and, even as late as that, the administration of ampicillin was followed by complete recovery of the patient. Conclusion. In younger, immunocompetent individuals, in spite of the existent diagnostic and therapeutic problems, the subacute course of Listeria monocytogenes meningitis provides enough time for appropriate treatment and favorable disease outcome. Apstrakt Uvod. Listeria monocytogenes je tre i naj eš i uzro nik bakterijskih meningitisa kod odraslih. Obi no poga a osobe sa poreme ajem elijski posredovanog imuniteta ili u odmaklom životnom dobu. Opisano je samo nekoliko bolesnika bez postoje e predispozicije. Prikaz bolesnika. U radu je prikazan osamnaestogodišnji, prethodno zdrav bolesnik, sa tipi nom klini kom slikom meningitisa. Na osnovu ambulantnog le enja ceftriaksonom i nalaza u cerebrospinalnoj te nosti postavljena je pretpostavka o parcijalno le enom bakterijskom meningitisu. Terapija, zapo eta vankomicinom i ceftriaksonom, koji je 4. dana zamenjen meropenemom, nije dala klini ko poboljšanje. Šestog dana od prijema iz cerebrospinalne te nosti izolovana je Listeria monocytogenes, a primena ampicilina, mada odložena, dovela je do potpunog oporavka bolesnika. Zaklju ak. Kod mladih, imunokompetentnih osoba, uprkos prisutnim dijagnosti kim i terapijskim problemima, subakutni tok meningitisa prouzrokovanog bakterijom Listeria monocytogenes omogu ava adekvatano le enje i povoljan ishod bolesti. Klju ne re i: meningitis; listeria monocytogenes; dijagnoza; le enje; antibiotici.