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Brain stem encephalitis in listeriosis
Ellen-Ann Antal1, Espen Dietrichs, Else Marit Løberg
1Department of Pathology, Ullevål University Hospital, Oslo, Norway. e.a.antal@ioks.uio.no
Scandinavian Journal of Infectious Diseases
|April 26, 2005
Summary
Listeria brain stem encephalitis, a severe L. monocytogenes infection, is often undiagnosed. This study found it occurred in 11% of adult listeriosis cases, highlighting its relative commonality.
Area of Science:
- Neurology
- Infectious Diseases
- Bacteriology
Background:
- Serious Listeria monocytogenes infections typically present as sepsis or meningitis.
- Listeria brain stem encephalitis is a distinct, potentially fatal neurological condition characterized by progressive brain stem deficits.
- Early diagnosis and treatment are crucial for survival.
Purpose of the Study:
- To determine the incidence of Listeria brain stem encephalitis within a population-based listeriosis cohort.
- To investigate clinical and neuropathological evidence of brain stem involvement in listeriosis patients.
Main Methods:
- Retrospective analysis of medical records from 212 patients with serious listeriosis in Norway (1977-2000).
- Review of autopsy materials from 8 patients.
- Search for clinical and neuropathological indicators of brain stem infection.
Main Results:
- Brain stem encephalitis findings were identified in 19 out of 172 adult listeriosis patients (11%).
- No cases of brain stem encephalitis were observed in 40 pregnancy-related listeriosis cases.
- None of the 19 identified patients were initially diagnosed with Listeria brain stem infection.
Conclusions:
- Listeria brain stem encephalitis is a relatively common, yet frequently overlooked, complication of serious listeriosis in adults.
- The findings underscore the importance of considering brain stem encephalitis in the differential diagnosis of unexplained neurological deficits in listeriosis patients.
- Improved diagnostic strategies are needed to identify this severe neurological manifestation of L. monocytogenes infection.