2020 Volume 53 Issue 1 Pages 54-60
An 86-year-old woman was originally given a diagnosis of left-sided colitis-type ulcerative colitis (UC) in 2008 and received treatment at another hospital. In February 2018, high fever and bloody stool were noted, and she was referred to our hospital because of UC exacerbation. The patient was found to be affected by a reduced level of consciousness and anemia progression, and total colectomy and ileostomy procedures were performed for acute exacerbation of UC. Following surgery, the level of consciousness did not improve and meningeal symptoms were observed, thus a cerebrospinal fluid examination was performed. Cerebrospinal fluid test findings showed elevated protein and cell counts, and a cerebrospinal fluid glucose/blood glucose ratio lower than 0.4, which led to a diagnosis of bacterial meningitis. Furthermore, preoperative blood culture findings revealed Listeria monocytogenes, thus the case was considered to be Listeria meningitis. The condition of the patient improved with antibiotic administration of ampicillin and gentamicin. This was an active UC case, in which bacterial invasion from the digestive tract was considered to have occurred.
