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Neurolisteriosis presenting as recurrent transient ischemic attacks

R Staudinger1, D Levine, B Swaminathan

  • 1Department of Neurology, New York University, NY 10016, USA.

Annals of Neurology
|October 12, 2000
PubMed

Insights

A rare case of Listeria monocytogenes meningitis caused fatal vasculitis in an elderly man, presenting initially with stroke-like symptoms. Prompt diagnosis and treatment are crucial for this severe bacterial infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pathology

Background:

  • Listeria monocytogenes is a foodborne bacterium that can cause serious infections, particularly in vulnerable populations.
  • Bacterial meningitis, an inflammation of the membranes surrounding the brain and spinal cord, can lead to severe neurological complications.

Observation:

  • An elderly male presented with transient ischemic attacks, including right arm weakness and expressive aphasia.
  • The patient subsequently developed fever and signs of meningitis, progressing to death over 9 weeks.
  • Necropsy revealed meningitis with vasculitis extending into the left frontal lobe.

Findings:

  • Polymerase chain reaction (PCR) confirmed Listeria monocytogenes as the causative agent.
  • The clinical presentation mimicked cerebrovascular events before the onset of meningitis.
  • Vasculitis was a prominent pathological finding, indicating severe inflammation of blood vessels in the brain.

Implications:

  • This case highlights the importance of considering infectious etiologies, such as Listeria meningitis, in elderly patients with recurrent neurological deficits.
  • Early and accurate diagnosis of Listeria monocytogenes infection is critical for effective management and potentially improving patient outcomes.
  • The study underscores the severe neurological consequences, including vasculitis, that can arise from untreated or refractory bacterial meningitis.

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