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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
Summary
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.