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Listeria monocytogenes Infection of the Brain
05:02

Listeria monocytogenes Infection of the Brain

Published on: October 2, 2018

Listeria spinal cord abscess responsive to trimethoprim-sulfamethoxazole monotherapy

F H Rossi1, J White, R Quisling

  • 1Department of Neurology, University of Florida, Gainesville, USA.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|January 5, 2002
PubMed
Abstract

Insights

Trimethoprim-sulfamethoxazole monotherapy offers a promising alternative for treating central nervous system Listeria monocytogenes infections. This approach may be suitable for critically ill patients, potentially reducing risks associated with traditional combination therapies.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Pharmacology

Background:

  • Central nervous system Listeria monocytogenes infections traditionally treated with ampicillin, gentamicin, and chloramphenicol.
  • Established therapies carry risks of nephrotoxicity, ototoxicity, and agranulocytosis.
  • Low antibiotic resistance in L. monocytogenes suggests alternative monotherapy options.

Observation:

  • A 58-year-old female presented with progressive quadriplegia and spinal cord lesions.
  • Cerebrospinal fluid, blood, and spinal cord biopsy cultures confirmed L. monocytogenes infection.
  • MRI revealed diffuse cervical and thoracic spine edema with ring-enhancing lesions.

Findings:

  • Intravenous trimethoprim-sulfamethoxazole monotherapy (8 mg/kg every 6 hours for 6 weeks) was administered.
  • The patient experienced arrest of neurological symptoms and clinical stabilization.
  • Neurological deficits improved, allowing discharge to a rehabilitation facility.

Implications:

  • Trimethoprim-sulfamethoxazole monotherapy presents a viable alternative for CNS L. monocytogenes infections.
  • This regimen may be particularly beneficial for critically ill patients.
  • Further research could validate trimethoprim-sulfamethoxazole as a standard alternative treatment.

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