Listeriosis and AIDS: case report and literature review

Silva, Luiz Jancintho da; Resende, Mariângela R.; Abreu, William B. de; Aoki, Fransisco H.; Bocatto, Raquel B.S.; Branchinni, Maria Luiza Moretti; Gonçales Jr., Fernando Lopes; Lima, Josué N. de; Nowakonski, Angela von; Papaiordanou, Priscila M. O.; Pedro, Rogério de Jesus; Rossi, Cláudio L.

doi:10.1590/S0036-46651992000500016

Abstracts

Listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in HIV-infected patients. This scarcity of reported cases has aroused interest in the association of listerosis and AIDS. In this paper we present a case of meningitis and septicemia caused by Listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems. Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.

Listeriosis; AIDS; Meningitis; Listeria meningitis; Septicemia

A listeriose é uma infecção não incomum, geralmente associada com recém-nascidos e pacientes imunodeprimidos que tem sido poucas vezes encontrada em pacientes com AIDS. Esta escassez de relatos despertou o interesse de diversos investigadores. Neste artigo, os autores relatam um caso de septicemia e meningite por Listeria monocytogenes em paciente com AIDS e fazem uma revisão da literatura. Novos conhecimentos sobre a interação agente - hospedeiro nas infecções por listeria, como o papel do fator de necrose tumoral e da integralina, estão permitindo novas interpretações da aparente escassez de infecções por listeria em pacientes com AIDS. O número de relatos vem crescendo em período recente, sugerindo que a associação pode ser mais freqüente do que aparenta ser, em parte explicada por inadequação no diagnóstico.

CASE REPORT

Listeriosis and AIDS: case report and literature review

Listeriose e AIDS: relato de caso e revisão de literatura

Luiz Jancintho da Silva^I; Mariângela R. Resende^I; William B. de Abreu^I; Fransisco H. Aoki^I; Raquel B.S. Bocatto^I; Maria Luiza Moretti Branchinni^I; Fernando Lopes Gonçales Jr.^I; Josué N. de Lima^I; Angela von Nowakonski^I; Priscila M. O. Papaiordanou^I; Rogério de Jesus Pedro^I; Cláudio L. Rossi^II

^IDisciplina de Moléstias Infecciosas, Deptº de Clínica Médica

^IIDepartamento de Patologia Clínica, Faculdade de Ciências Médicas UNICAMP

^{Address for correspondence} Address for correspondence: L. J. da Silva Cx Postal 6019 - UNICAMP 13.081 Campinas, SP. Brasil

SUMMARY

Listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in HIV-infected patients. This scarcity of reported cases has aroused interest in the association of listerosis and AIDS.

In this paper we present a case of meningitis and septicemia caused by Listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems.

Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.

Keywords: Listeriosis; AIDS; Meningitis; Listeria meningitis; Septicemia

RESUMO

A listeriose é uma infecção não incomum, geralmente associada com recém-nascidos e pacientes imunodeprimidos que tem sido poucas vezes encontrada em pacientes com AIDS. Esta escassez de relatos despertou o interesse de diversos investigadores.

Neste artigo, os autores relatam um caso de septicemia e meningite por Listeria monocytogenes em paciente com AIDS e fazem uma revisão da literatura.

Novos conhecimentos sobre a interação agente - hospedeiro nas infecções por listeria, como o papel do fator de necrose tumoral e da integralina, estão permitindo novas interpretações da aparente escassez de infecções por listeria em pacientes com AIDS.

O número de relatos vem crescendo em período recente, sugerindo que a associação pode ser mais freqüente do que aparenta ser, em parte explicada por inadequação no diagnóstico.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Recebido para publicação em 13/1/1992

Aceito para publicação em 15/5/1992

1. ARMSTRONG, D. - Listeria monocytogenes. In: MANDELL, G.L.; DOUGLAS Jr., R.G. & BENNET, J.E., ed. - Principies and practice of infectious diseases. 3. ed. New York, Churchill Livingstone, 1990. p. 1587-1593.
2. BERENGUER, J.; SOLERA J.; DIAZ, M.D.; MORENO, S.; LOPEZ-HERCE, J.A. & BOUZA, E. - Listeriosis in patients infected with human immunodeficiency virus. Rev. infect. Dis., 13: 115-119, 1991.
3. CARVALHO, V.O.; AYROSA-GALVĂO, P.A.; KUSHNAROFF, T.M.; CAMPOS E.P. & CAMPOS, C.E.O.P. - Aspectos clínicos-laboratorais de 11 doentes com listeriose - Hospital Emílio Ribas - SP. In: CONGRESSO BRASILEIRO DE INFECTOLOGIA, 4. Salvador, 1991. Anais. p.44.
4. CENTERS FOR DISEASE CONTROL - Classification system for human T-lymphotropic virus type III / lymphadenopathy-associated virus infections. MMWR, 35: 334-339, 1986.
5. CENTERS FOR DISEASE CONTROL - Human immunodeficiency virus (HIV) infection codes: official authorized addendum ICD-9-CM effective January 1, 1988. MMWR, 36 (S7): 1-24, 1987.
6. CENTERS FOR DISEASE CONTROL - Revision of the CDC surveillance case definition Tor acquired immunodeficiency syndrome. J. Amer. med. Ass., 258: 1143-1154, 1987.
7. DECKER, C.F.; SIMON, G.L.; DIGIOIA, R.A. & TUAZON, C.U. - Listeria monocytogenes in patients with AIDS: report of five cases and review. Rev. infect. Dis., 13: 413-417, 1991.
8. FALKOW, S. - Bacterial entry into eukaryocitic cells. Cell 65: 1099-1102, 1991.
9. FLEMING, A.F. - Opportunistic infections in AIDS in developed and developing countries. Trans. roy. Soc. trop. Med. Hyg., 84 (supl.1): 1-6, 1989.
10. GAILLARD, J.L.; BERCHE, P.; FREHEL, C.; GOUIN, E. & COSSART, P. - Entry of L. monocytogenes into cells is mediated by internalin, a repeat protein reminiscent of surface antigens from Gram-positive cocci. Cell, 65: 1127-1141, 1991.
11. GELLIN, B.G. & BROOME, C.V. - Listeriosis. J. Amer. med. Ass., 261: 1313-1320, 1989.
12. JACOBS, J.L. & MURRAY, H.M. - Why is Listeria monocytogenes not a pathogen in the acquired immunodeficiency syndrome? Arch. intern. Med. ,146: 1299-1300, 1986.
13. KALES, C.P. & HOLZMANN, R.S. - Listeriosis in patients with HIV infection: clinical manifestations and response to therapy. J. Acq. Immune Def. Syndr., 3: 139-143, 1990.
14. REAL, F.X.; GOLD, J.W.M.; KROWN, S.E. & ARMSTRONG, D. - Listeria monocytogenes bacteremia in the acquired immunodeficiency syndrome [letter]. Ann. intern. Med.,101: 883-884, 1984.
15. SANTA ROSA, C.A.; KIPNIS, J.; OSELKA, G.W.; TCHERNIACOUSKI, I. & AMATO NETO, V. - Inquérito sorológico relativo a listeriose em moradores da cidade de Săo Paulo. Rev. Soc. bras. Med. trop., 4 (supl.): 39-40, 1970.
16. SANTA ROSA, C.A.; GOMES, M.C.O.; TERUYA, J.M. & COSCINA, A.L. - Estudo sorológico para listeriose em doentes mentais. Rev. Inst. Med. trop. S. Paulo, 16: 222-225, 1974.
17. WETLI, C.V.; ROLDAN, E.O. & FOJACO, R.M. - Listeriosis as a cause of maternal death: an obstetric complication of the adquired immunodeficiency syndrome (AIDS). Amer. J. Obstet. Gynec., 147: 7-9, 1983.

Address for correspondence:

L. J. da Silva

Cx Postal 6019 - UNICAMP

13.081 Campinas, SP. Brasil

Publication Dates

Publication in this collection
13 Sept 2006
Date of issue
Oct 1992

History

Received
13 Jan 1992
Accepted
15 May 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARMSTRONG, D. - Listeria monocytogenes. In: MANDELL, G.L.; DOUGLAS Jr., R.G. & BENNET, J.E., ed. - Principies and practice of infectious diseases. 3. ed. New York, Churchill Livingstone, 1990. p. 1587-1593.

[2] 2. BERENGUER, J.; SOLERA J.; DIAZ, M.D.; MORENO, S.; LOPEZ-HERCE, J.A. & BOUZA, E. - Listeriosis in patients infected with human immunodeficiency virus. Rev. infect. Dis., 13: 115-119, 1991.

[3] 3. CARVALHO, V.O.; AYROSA-GALVĂO, P.A.; KUSHNAROFF, T.M.; CAMPOS E.P. & CAMPOS, C.E.O.P. - Aspectos clínicos-laboratorais de 11 doentes com listeriose - Hospital Emílio Ribas - SP. In: CONGRESSO BRASILEIRO DE INFECTOLOGIA, 4. Salvador, 1991. Anais. p.44.

[4] 4. CENTERS FOR DISEASE CONTROL - Classification system for human T-lymphotropic virus type III / lymphadenopathy-associated virus infections. MMWR, 35: 334-339, 1986.

[5] 5. CENTERS FOR DISEASE CONTROL - Human immunodeficiency virus (HIV) infection codes: official authorized addendum ICD-9-CM effective January 1, 1988. MMWR, 36 (S7): 1-24, 1987.

[6] 6. CENTERS FOR DISEASE CONTROL - Revision of the CDC surveillance case definition Tor acquired immunodeficiency syndrome. J. Amer. med. Ass., 258: 1143-1154, 1987.

[7] 7. DECKER, C.F.; SIMON, G.L.; DIGIOIA, R.A. & TUAZON, C.U. - Listeria monocytogenes in patients with AIDS: report of five cases and review. Rev. infect. Dis., 13: 413-417, 1991.

[8] 8. FALKOW, S. - Bacterial entry into eukaryocitic cells. Cell 65: 1099-1102, 1991.

[9] 9. FLEMING, A.F. - Opportunistic infections in AIDS in developed and developing countries. Trans. roy. Soc. trop. Med. Hyg., 84 (supl.1): 1-6, 1989.

[10] 10. GAILLARD, J.L.; BERCHE, P.; FREHEL, C.; GOUIN, E. & COSSART, P. - Entry of L. monocytogenes into cells is mediated by internalin, a repeat protein reminiscent of surface antigens from Gram-positive cocci. Cell, 65: 1127-1141, 1991.

[11] 11. GELLIN, B.G. & BROOME, C.V. - Listeriosis. J. Amer. med. Ass., 261: 1313-1320, 1989.

[12] 12. JACOBS, J.L. & MURRAY, H.M. - Why is Listeria monocytogenes not a pathogen in the acquired immunodeficiency syndrome? Arch. intern. Med. ,146: 1299-1300, 1986.

[13] 13. KALES, C.P. & HOLZMANN, R.S. - Listeriosis in patients with HIV infection: clinical manifestations and response to therapy. J. Acq. Immune Def. Syndr., 3: 139-143, 1990.

[14] 14. REAL, F.X.; GOLD, J.W.M.; KROWN, S.E. & ARMSTRONG, D. - Listeria monocytogenes bacteremia in the acquired immunodeficiency syndrome [letter]. Ann. intern. Med.,101: 883-884, 1984.

[15] 15. SANTA ROSA, C.A.; KIPNIS, J.; OSELKA, G.W.; TCHERNIACOUSKI, I. & AMATO NETO, V. - Inquérito sorológico relativo a listeriose em moradores da cidade de Săo Paulo. Rev. Soc. bras. Med. trop., 4 (supl.): 39-40, 1970.

[16] 16. SANTA ROSA, C.A.; GOMES, M.C.O.; TERUYA, J.M. & COSCINA, A.L. - Estudo sorológico para listeriose em doentes mentais. Rev. Inst. Med. trop. S. Paulo, 16: 222-225, 1974.

[17] 17. WETLI, C.V.; ROLDAN, E.O. & FOJACO, R.M. - Listeriosis as a cause of maternal death: an obstetric complication of the adquired immunodeficiency syndrome (AIDS). Amer. J. Obstet. Gynec., 147: 7-9, 1983.