Listeria rhombencephalitis in the postpartum period

Area of Science:

• Neurology
• Infectious Diseases
• Obstetrics

Background:

• Listeria rhombencephalitis is a rare but severe infection affecting the brainstem.
• Postpartum women are a vulnerable population for certain infections.
• Neurologic deficits and fever in postpartum women warrant thorough investigation.

Purpose of the Study:

• To report a case of Listeria rhombencephalitis in a postpartum woman.
• To emphasize the diagnostic challenges and clinical presentation.
• To highlight the importance of timely intervention.

Main Methods:

• Case report of a healthy woman in her late 30s, 6 weeks postpartum.
• Diagnosis confirmed via cerebrospinal fluid (CSF) PCR for Listeria monocytogenes and contrast-enhanced brain MRI.
• Treatment involved an 8-week course of ampicillin and gentamicin.

Main Results:

• The patient presented with acute fever, headache, and neurologic deficits.
• MRI revealed multiple brainstem abscesses.
• Complications included aspiration pneumonia and respiratory failure, requiring intubation.
• The patient improved with treatment but had residual hemiparesis and cranial neuropathy.

Conclusions:

• Listeria rhombencephalitis should be considered in postpartum women with fever and neurologic symptoms, even without meningeal signs.
• Early diagnosis using CSF PCR and MRI is crucial.
• Prompt antibiotic treatment can reduce mortality and neurological sequelae.