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Updated: Aug 8, 2026

Listeria monocytogenes Infection of the Brain
Published on: October 2, 2018
Listeria brain abscess, Pneumocystis pneumonia and Kaposi's sarcoma after temozolomide
Vincent Ganière1, Grégoire Christen, Frank Bally
1University of Lausanne Hospitals, Lausanne, Switzerland.
Background:
A 55-year-old man with glioblastoma multiforme was treated with continuous, dose-dense temozolomide. This therapy was curtailed after three cycles because of nausea, asthenia, and neuropsychological deterioration. During a subsequent course of radiotherapy, the patient developed fever, headaches, and cutaneous lesions.
Investigations:
Physical examination, cerebral MRI, brain biopsy, skin biopsy, immunohistochemistry, bronchoscopy with bronchoalveolar lavage, and laboratory tests.
Diagnosis:
Severe temozolomide-induced immunosuppression, exacerbated by corticosteroids, with profound T-cell lymphocytopenia and simultaneous opportunistic infections with Pneumocystis jiroveci pneumonia, brain abscess with Listeria monocytogenes, and cutaneous Kaposi's sarcoma.
Management:
Discontinuation of temozolomide, discontinuation of radiotherapy, antibiotic treatment with amoxicillin and gentamicin, and administration of atovaquone and pentamidine.
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