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Persistent Listeria monocytogenes Cerebritis Mimicking Cerebral Metastases Due to Melanoma

Samantha Levin1, Jordan N Houser1, Hiba Siblini2

  • 1Neurology, Rush University Medical Center, Chicago, USA.

Cureus
|July 22, 2024
PubMed

Insights

Listeria cerebritis, a rare CNS infection, can mimic cancer metastasis. Prompt diagnosis and prolonged antibiotic treatment (ampicillin, gentamicin, linezolid) are crucial for recovery, especially in immunocompromised patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Oncology

Background:

  • Listeria cerebritis is a rare but severe central nervous system infection.
  • Leptomeningeal disease in cancer patients is often misdiagnosed as metastasis.
  • Early recognition of infectious causes is critical for appropriate management.

Observation:

  • A patient with metastatic melanoma presented with focal motor seizures and left-sided weakness.
  • Diagnostic workup revealed a leptomeningeal abscess secondary to Listeria cerebritis.
  • Cerebrospinal fluid analysis was initially bland, highlighting diagnostic challenges.

Findings:

  • The patient received an eight-week course of ampicillin, gentamicin, and linezolid.
  • Clinical improvement was observed following the prolonged antibiotic therapy.
  • Listeria infection requires consideration even with unremarkable cerebrospinal fluid findings.

Implications:

  • This case underscores the importance of considering infectious etiologies, like Listeria, in cancer patients with neurological symptoms.
  • Prolonged antibiotic treatment may be necessary for immunocompromised individuals with Listeria cerebritis.
  • Accurate diagnosis and timely intervention are key to managing this serious infection and improving patient outcomes.
Keywords:
brain biopsybrain metastasiscns infectionglucocorticoidsimmunocompromiseinfectious diseaseinfectious disease pathologylisteriamalignant melanoma metastasisnew-onset seizure

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