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Updated: Aug 19, 2026

Listeria monocytogenes Infection of the Brain
Published on: October 2, 2018
[Brain abscesses due to Listeria monocytogenes]
M T Adeva-Bartolomé1, F J de Castro-García, F Castellanos-Pinedo
1Unidad de Neurología, Servicio de Medicina Interna, Hospital Virgen del Puerto. mtfj@eresmas.com
Introduction:
Listeria monocytogenes is a gram-positive bacillus which causes sporadic infections in immunocompromised humans, with a special propensity for the central nervous system, in the form of acute, subacute or chronic meningitis, rhombencephalitis or abscesses in the brain or spinal cord. The final diagnosis is established by germ culture in blood or in cerebrospinal fluid (CSF). Preferred treatment is ampicillin in association with aminoglycosides.
Case Report:
We report the case of a 70-year-old male patient with a history of arterial hypertension and chronic lymphatic leukaemia with no specific treatment, who suffered meningoencephalitis and brain abscesses caused by L. monocytogenes. Symptoms were a 48-hour history of headache and a febrile condition. The CSF showed lymphocytic pleocytosis with hypoglycorrhachia. Magnetic resonance scans of the brain revealed areas of cerebritis and multiple brain abscesses in the right frontal lobe. Specific treatment was established with ampicillin for 13 weeks, associated with gentamicin and vancomycin during the first few weeks, until x-rays showed the lesions to be resolved.
Conclusions:
L. monocytogenes infections must be investigated in all patients with cellular immunosuppression who present febrile symptoms. The central nervous system may be the only area of the body infected. Moreover, this site will need studying in patients who present neurological focus data or an alteration in the state of consciousness and bacteraemia due to L. monocytogenes. Establishing suitable treatment as early as possible can improve the prognosis.
Insights
Listeria monocytogenes can cause severe central nervous system infections, including brain abscesses, particularly in immunocompromised individuals. Prompt diagnosis and treatment with antibiotics like ampicillin are crucial for improving patient outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Listeria monocytogenes is a gram-positive bacterium known to cause central nervous system infections in immunocompromised hosts.
- These infections can manifest as meningitis, rhombencephalitis, or brain/spinal cord abscesses.
Observation:
- A 70-year-old male with chronic lymphatic leukemia presented with meningoencephalitis and brain abscesses caused by L. monocytogenes.
- Cerebrospinal fluid analysis revealed lymphocytic pleocytosis and hypoglycorrhachia.
- Brain MRI demonstrated cerebritis and multiple abscesses in the right frontal lobe.
Findings:
- The patient was treated with a 13-week course of ampicillin, combined with gentamicin and vancomycin initially.
- Radiological evidence confirmed the resolution of brain lesions following treatment.
Implications:
- Listeria monocytogenes infections warrant investigation in immunocompromised patients with febrile illnesses, especially with neurological symptoms.
- The central nervous system can be the primary site of infection.
- Early and appropriate antibiotic therapy, such as ampicillin with aminoglycosides, is vital for a better prognosis.
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