Related Experiment Videos
[Rhombencephalitis caused by Listeria monocytogenes]
1Servicio de Neurología, Hospital General de Galicia, Clínico Universitario, Santiago de Compostela, La Coruña.
Abstract:
The observation of an abscess in the brain stem and cerebellum due to Listeria monocytogenes is presented. The patient was a 55 year old diabetic, alcoholic, gastrectomized male in whom a febrile and meningeal syndrome developed. Three days later he had a progressive unilateral dysfunction of the cranial nerves. The cerebrospinal fluid showed pleocytosis of the polymorphonuclear cells, an increase in proteins and low glucose in relation with the glycemia. No parenchymatous lesion was observed upon emergency computerized tomography. Magnetic resonance imaging showed a hyper-signal lesion in the brain stem and cerebellum with a contrast enhancement in ring. Following antibiotic treatment the clinical evolution of the patient was favorable with slight focal sequelae persistent at discharge. A review of the epidemiology, clinical manifestations and treatment of this infection is carried out.
Insights
Listeria monocytogenes caused a brainstem and cerebellar abscess in a patient with multiple risk factors. Prompt antibiotic treatment led to favorable outcomes with minor residual neurological deficits.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Listeria monocytogenes is a bacterial pathogen that can cause serious infections, particularly in immunocompromised individuals.
- Brain abscesses are rare but life-threatening conditions requiring prompt diagnosis and treatment.
- Risk factors such as diabetes, alcoholism, and prior gastrointestinal surgery can increase susceptibility to Listeria infections.
Observation:
- A 55-year-old male with diabetes, alcoholism, and a history of gastrectomy presented with fever and meningeal signs.
- The patient developed progressive unilateral cranial nerve dysfunction.
- Cerebrospinal fluid analysis revealed pleocytosis, elevated protein, and low glucose levels.
Findings:
- Initial computed tomography (CT) scan showed no parenchymal lesions.
- Magnetic resonance imaging (MRI) revealed a hyperintense lesion in the brainstem and cerebellum with ring enhancement, indicative of an abscess.
- Listeria monocytogenes was identified as the causative agent.
Implications:
- This case highlights the importance of advanced imaging techniques like MRI for diagnosing brain abscesses when CT is inconclusive.
- Early antibiotic intervention is crucial for favorable outcomes in Listeria brain abscesses.
- Understanding the risk factors and clinical presentation aids in the timely diagnosis and management of this severe infection.