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Published on: August 9, 2011
Multiple Listeria Abscesses in an Immunocompetent Patient
Heitor C Frade1, Chandra Pingili1, Premkumar Nattanamai1
1Neurology, University of Missouri, Columbia, USA.
Abstract:
Listeria monocytogenes is a ubiquitous organism that can potentially cause gastroenteritis and, less commonly, central nervous system infections. Brain abscess is rare and often associated with immunocompromised status. We report a case of multiple abscesses caused by Listeria in a previously immunocompetent elderly patient who developed a headache and left-sided hemiparesis over the course of days. Neuroimaging studies revealed multiple ring-enhancing lesions in the brain and midbrain territories. Blood culture, brain tissue aspirate, and cerebrospinal fluid nucleic acid amplification test were positive for Listeria. Extensive immunologic workup revealed no primary or secondary immunodeficiency disorders. After the initiation of antibiotics, the patient showed gradual clinical improvement and went to a skilled nursing facility after two weeks.
Insights
This case study highlights a rare instance of multiple brain abscesses caused by Listeria monocytogenes in an immunocompetent elderly patient. Prompt antibiotic treatment led to clinical improvement, underscoring the importance of timely diagnosis and intervention for CNS Listeria infections.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Listeria monocytogenes can cause central nervous system infections, with brain abscesses being a rare manifestation.
- Brain abscesses are typically associated with compromised immune systems.
Observation:
- An elderly, previously immunocompetent patient presented with headache and left-sided hemiparesis.
- Neuroimaging identified multiple ring-enhancing brain lesions.
- Listeria monocytogenes was confirmed via blood, CSF, and brain tissue analysis.
Findings:
- The patient had no identifiable primary or secondary immunodeficiency disorders.
- Despite the absence of immunocompromise, Listeria monocytogenes caused multiple brain abscesses.
Implications:
- This case expands the understanding of Listeria monocytogenes CNS infection presentations.
- It emphasizes the need for considering Listeria in the differential diagnosis of brain abscesses, even in immunocompetent individuals.
- Early antibiotic therapy is crucial for favorable outcomes in CNS Listeria infections.
