Meningitis caused by Listeria monocytogenes in a locally advanced cervical cancer patient with pyometra: A case report

Yusuke Matoba, Hiroshi Nishio, Koji Sekiguchi, Shunsuke Uno, Kenta Masuda, Makiko Hiramatsu, Mio Takahashi, Maki Oishi, Yoshifumi Uwamino, Sho Uchida, Yugaku Daté, Tohru Morisada, Kouji Banno, Jin Nakahara, Daisuke Aoki

研究成果: Article査読

抄録

Locally advanced cervical cancer occasionally induces pyometra, but there have been no reports of meningitis where pyometra is the cause of infection. Here, we report a case of Listeria monocytogenes meningitis related to pyometra during concurrent chemoradiotherapy (CCRT) in a cervical cancer patient. The patient, a 77-year-old woman, was diagnosed with Stage IIB (FIGO 2018) cervical adenocarcinoma, and CCRT was initiated. Pyometra was exacerbated during CCRT, and after her first brachytherapy, she presented at our hospital with fever and decreased consciousness level. After admission to the Intensive Care Unit, the patient lost consciousness and experienced frequent seizures; tracheal intubation was required. Whole-body computed tomography revealed pyometra; therefore, transvaginal removal of the abscess was performed. Laboratory tests and vital signs indicated septic shock, and meropenem was administered. L. monocytogenes was detected in the abscess from the uterine cavity and the blood cultures on the third day of hospitalization. A lumbar puncture was performed on the same day to investigate whether the patient had meningitis. A FilmArray meningitis/encephalitis panel test of the spinal fluid revealed L. monocytogenes. After the diagnosis of meningitis with L. monocytogenes, ampicillin and gentamicin were started, and the blood test results gradually improved. Five months after the initial episode, her consciousness recovered, however she still received mechanical ventilatory support. L. monocytogenes infections can occur in patients undergoing chemotherapy, even without the use of steroids or immunosuppressive agents. In cases with pyometra, intrauterine manipulation can increase the risk of severe infection.

本文言語English
論文番号100799
ジャーナルGynecologic Oncology Reports
37
DOI
出版ステータスPublished - 2021 8

ASJC Scopus subject areas

  • 腫瘍学
  • 産婦人科学

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