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An unusual presentation of paediatric Listeria meningitis with selective spinal grey matter involvement and acute demyelinating polyneuropathy.

AbstractBACKGROUND:
Paediatric Listeria meningitis is rare, especially in immuno-competent children, but associated with significant mortality and morbidity and frequent complications.
METHODS:
We report an unusual case of Listeria meningitis in a previously healthy 35 month-old girl with selective spinal grey matter involvement and demyelination in neurophysiological studies. Despite adequate antibiotic treatment, the case was initially complicated by ventriculitis, hydrocephalus and tonsillar herniation through the foramen magnum, requiring external ventricular drainage and subsequent ventriculoperitoneal shunt insertion. Paucity of movements, hypotonia, areflexia and bladder dysfunction then became evident.
RESULTS:
Electromyogram and nerve conduction studies showed acute inflammatory demyelinating polyneuropathy and the patient received intravenous immunoglobulin followed by corticosteroids. MRI scans with contrast revealed extensive whole cord selective grey matter signal changes. She required extensive neurorehabilitation, making gradual (but incomplete) recovery.
CONCLUSION:
Spinal cord involvement is rare in neuro-listeriosis and there no previous paediatric reports of Listeria-related myelitis or demyelinating polyneuropathy. The mechanism behind these presentations is unclear but an auto-immune response to the infection might be considered.
AuthorsA Papandreou, A Hedrera-Fernandez, M Kaliakatsos, W K Chong, S Bhate
JournalEuropean journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society (Eur J Paediatr Neurol) Vol. 20 Issue 1 Pg. 196-9 (Jan 2016) ISSN: 1532-2130 [Electronic] England
PMID26371981 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Topics
  • Child, Preschool
  • Female
  • Gray Matter (pathology)
  • Guillain-Barre Syndrome (microbiology, pathology)
  • Humans
  • Hydrocephalus (etiology)
  • Magnetic Resonance Imaging
  • Meningitis, Listeria (complications, pathology)
  • Spinal Cord Diseases (microbiology, pathology)

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