Clinical and Radiological Profile of Patients Presenting with Neurolisteriosis: A retrospective study from a Tertiary Care Hospital

Abstract

Background
Neurolisteriosis, a central nervous system (CNS) infection caused by Listeria monocytogenes, is associated with significant morbidity and mortality, particularly in elderly and immunocompromised individuals. The objective of this study was to analyze the clinical and radiological data from the patients of this disease presenting to a tertiary care hospital.

Methods
This retrospective review analyzed clinical, laboratory, and neuroimaging data from 12 patients diagnosed with neurolisteriosis at Aga Khan University Hospital between September 2018 and March 2024. Diagnosis was confirmed through blood and/or cerebrospinal fluid cultures or polymerase chain reaction assays. Data was analyzed using Statistical Package for Social Sciences (version 25.0).

Results
The median age was 68.5 years, with 58.3% being elderly (>65 years) and 58.3% male. Most patients (91.7%) had underlying comorbidities, with diabetes mellitus and hypertension being the most common. Acute onset of symptoms was observed in two-thirds of cases. Fever (83.3%) and altered consciousness (75%) were the predominant presenting features. Meningeal enhancement was the most frequent neuroimaging finding (66.6%), followed by hydrocephalus (25%). The median time to radiological diagnosis (24 hours) was significantly shorter than to microbiological confirmation (72 hours). The mortality rate was 25%, with complicated clinical courses observed in 75% of patients.

Conclusion
Neurolisteriosis predominantly affects elderly and immunocompromised populations and presents with non-specific CNS infection symptoms. MRI plays a crucial role in early detection and management, given the delay in microbiological confirmation. Heightened clinical suspicion and prompt imaging can improve diagnosis and outcomes.