抄録
A 74-year-old woman receiving long-term prednisolone for cardiac sarcoidosis presented with altered consciousness. Prophylactic trimethoprim-sulfamethoxazole (TMP-SMX) had been discontinued 10 months prior due to hyperkalemia. Blood cultures identified Listeria monocytogenes and central nervous system involvement was suspected. Treatment with intravenous ampicillin and gentamicin were completed without neurological sequelae. Invasive listeriosis should be considered in immunocompromised elderly patients presenting with altered mental status, particularly those not receiving TMP-SMX prophylaxis. This case suggests a potential protective role for TMP-SMX against listeriosis in this population.
