Case Report: A 96-year-old woman who had been living alone was found to have
SARS-CoV-2 infection in February 2023. She was admitted to our hospital with high
fever and disturbance of consciousness and was started on treatment with
remdesivir. Two days later, her consciousness was still disturbed, and she was found to have a stiff neck. In addition, increased white blood cell counts and
C-reactive protein suggested
bacterial infection. Therefore, a lumbar puncture was done, and Listeria monocytogenes was ultimately isolated from blood cultures and its genetic material was detected in cerebrospinal fluid. She had previously eaten refrigerated food and cheese products. Intravenous
ampicillin 1.0 g 6×/day was started, but one week later,
loss of consciousness continued, and the cerebrospinal findings were not improved, although nasal swab became negative for SARS-CoV-2. Intravenous
sulfamethoxazole/
trimethoprim (ST) 80/400 mg 3×/day was added, and her consciousness and
fever improved by one week later. A
drug rash appeared after ST was started, and she was switched to
meropenem. Her condition finally improved.
Conclusion: