A case report of oral sulfamethoxazole in the treatment of posttransplant Listeria monocytogenes meningitis Original paper
Researched by:
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Divine Aleru
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Divine Aleru
Read MoreI am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Microbes
Microbes
Microbes are microscopic organisms living in and on the human body, shaping health through digestion, vitamin production, and immune protection. When microbial balance is disrupted, disease can occur. This guide explains key microbe types—bacteria, viruses, fungi, protozoa, and archaea—plus major pathogenic and beneficial examples.
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Divine Aleru
Read More
Researched by:
-
Divine Aleru
ID
Divine Aleru
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was studied?
This case report studied the use of oral sulfamethoxazole (TMP-SMX) in the treatment of Listeria monocytogenes meningitis in a renal transplant recipient. The research aimed to examine the effectiveness of TMP-SMX, an antibiotic commonly used for various bacterial infections, when administered orally as an alternative to intravenous therapies, particularly for patients who are allergic to penicillin.
Who was studied?
The study focused on a 30-year-old male who had received a kidney transplant 4 months prior. He was diagnosed with Listeria monocytogenes meningitis after presenting with symptoms such as headache, diarrhea, fever, and neurological issues. The patient had a history of regular immunosuppressive therapy following the transplant, which made him susceptible to infections like Listeria. The study followed his treatment regimen and response to oral TMP-SMX therapy.
What were the most important findings?
The key finding from this case report was that oral TMP-SMX was effective in treating Listeria monocytogenes meningitis in this patient, who was allergic to penicillin and could not receive the conventional antibiotic therapy. The patient, after being diagnosed with Listeria through blood and cerebrospinal fluid (CSF) cultures, was initially treated with penicillin. However, due to an allergic reaction, he was switched to oral TMP-SMX. The patient tolerated the TMP-SMX well, showing significant improvement after 21 days of treatment. His clinical symptoms improved, and follow-up tests showed normal CSF results, with no recurrence of meningitis or deterioration in kidney function. The study also highlighted that, despite the lack of intravenous TMP-SMX in some regions, the oral formulation proved to be an effective alternative with comparable bioavailability to the intravenous form.
What are the greatest implications of this study?
This study demonstrates that oral TMP-SMX can be a viable treatment option for Listeria monocytogenes meningitis in patients who cannot tolerate penicillin or intravenous treatments. The case adds to the growing body of evidence supporting the use of oral TMP-SMX in severe infections, particularly in immunocompromised patients, such as those with organ transplants. It also raises the potential for oral TMP-SMX to be considered in other settings where penicillin is contraindicated, making it a useful addition to treatment protocols for Listeria infections. Furthermore, this case could influence future clinical practices by offering a practical alternative to intravenous antibiotics, especially in regions where intravenous formulations of TMP-SMX are not readily available.
Listeria monocytogenes
Listeria monocytogenes is an opportunistic pathogen capable of surviving in diverse environments, including soil, water, and decaying vegetation. L. monocytogenes has the unique ability to evade the immune system by moving directly from cell to cell within the host. This intracellular lifestyle allows the bacterium to avoid extracellular immune detection, contributing to its ability to cause invasive diseases like meningitis and septicemia, particularly in the elderly and immunocompromised.