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Listeria monocytogenes Infection of the Brain
Published on: October 2, 2018
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Rhombencephalitis due to Listeria monocytogenes
1Wellstar Infectious Disease, Marietta, GA, USA.
Idcases
|April 14, 2021
Summary
Brain stem encephalitis, a rare form of central nervous system (CNS) listeriosis, has high mortality. This case highlights the severe, fatal progression of CNS listeriosis despite treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroimmunology
Background:
- Central nervous system (CNS) listeriosis is a severe infection caused by Listeria monocytogenes.
- Brain stem encephalitis is a rare and often fatal manifestation of CNS listeriosis.
- Patients with immunosuppression, such as those on methotrexate for dermatomyositis, are at increased risk.
Observation:
- A 46-year-old male with a history of dermatomyositis on methotrexate presented with fever, headache, asymmetrical cranial nerve palsy, and right hemiparesis.
- Magnetic Resonance Imaging (MRI) revealed ring-enhancing lesions in the medulla oblongata.
- Cerebrospinal fluid (CSF) cultures confirmed the presence of Listeria monocytogenes.
Findings:
- Despite treatment with ampicillin and gentamicin, the patient experienced severe neurological complications.
- These rare manifestations included rhombencephalitis, hydrocephalus, and brainstem hemorrhage.
- The patient ultimately did not survive, underscoring the aggressive nature of this infection.
Implications:
- This case emphasizes the critical importance of early detection and prompt treatment of CNS listeriosis.
- Aggressive management strategies are crucial to improve outcomes in high-risk patients.
- Understanding the rare complications of neurolisteriosis is vital for clinicians managing such cases.
