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Listeria monocytogenes Meningitis Associated with Rhabdomyolysis and Acute Renal Failure
Authors:Marko Kutleša  Dragan Lepur  Suzana Bukovski  Nevija Kalabrić Lepur  Bruno Baršić
Affiliation:(1) Department of Neuroinfections and Intensive Care Medicine, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Mirogojska 8, 10000 Zagreb, Croatia;(2) Department of Microbiology, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia;(3) Private Pediatric Practice “Dr. Željko Vokić”, Zagreb, Croatia
Abstract:Introduction  Numerous systemic infections are capable of inducing myositis and rhabdomyolysis. Clinical course of the disease is in the great majority of patients benign and without development of renal dysfunction. However, serious consequences are possible if acute renal failure (ARF) occurs, especially in critically ill patients. Methods  Patient with Listeria monocytogenes meningitis associated with rhabdomyolysis and acute non-oliguric ARF is presented. Results  Sixty-nine-year-old white male was admitted to our intensive care unit because of listerial meningitis. The course of the disease was complicated with rhabdomyolysis and non-oliguric ARF. After antimicrobial treatment with parenteral trimethoprim-sulfamethoxazole and 4 days of continuous veno-venous hemodiafiltration (CVVHDF) the patient recovered. Conclusion  We report a case of listerial meningitis complicated with non-oliguric ARF. Rhabdomyolysis should be considered in all patients with infection and increased CK, especially if consciousness is impaired is altered. Furthermore, despite the normal diuresis ARF could be present and result in adverse consequences. We infer that timely diagnosis and treatment should improve the outcome of infection-induced rhabdomyolysis and could prevent a proportion of associated ARF.
Keywords:Listeria monocytogenes   Rhabdomyolysis  Meningitis  Creatine kinase  Acute renal failure
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