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Updated: Jun 30, 2026

Listeria monocytogenes Infection of the Brain
05:02

Listeria monocytogenes Infection of the Brain

Published on: October 2, 2018

A Culture-negative Refractory Brain Abscess Presumed to be Caused by Listeria Monocytogenes via a Pulmonary

Motohiro Okumura1, Kenichi Sakuta1, Tafu Watatani2

  • 1Department of Neurology, The Jikei University School of Medicine, Japan.

Internal Medicine (Tokyo, Japan)
|June 28, 2026
PubMed

Insights

A probable Listeria monocytogenes brain abscess presented with unique imaging findings and responded to antibiotics. The condition relapsed after treatment cessation, suggesting a potential link to an underlying pulmonary arteriovenous malformation.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Brain abscesses can present with diverse neurological symptoms.
  • Listeria monocytogenes is a potential cause of brain abscesses, particularly in certain patient populations.
  • Tract-based lesions along the corticospinal tract are uncommon presentations of brain abscesses.

Purpose of the Study:

  • To report a rare case of a probable Listeria monocytogenes brain abscess.
  • To highlight the characteristic imaging features of tract-based lesions.
  • To discuss the diagnostic challenges and treatment implications.

Main Methods:

  • Clinical presentation of a 59-year-old male with fever, headache, and hemiparesis.
  • Brain MRI demonstrating an elongated, tubular, rim-enhancing lesion along the corticospinal tract.
  • Evaluation of treatment response to ampicillin and trimethoprim-sulfamethoxazole, including relapse after discontinuation.
  • Comprehensive microbiological investigations (blood/CSF cultures, PCR) and autopsy.
  • Retrospective analysis of imaging for potential predisposing factors.

Main Results:

  • The lesion showed a selective radiological response to ampicillin and trimethoprim-sulfamethoxazole.
  • The patient experienced a relapse after discontinuing antibiotic treatment.
  • No pathogens were identified through extensive microbiological testing or autopsy.
  • Retrospective imaging identified a small pulmonary arteriovenous malformation.
  • The case was clinically diagnosed as a probable Listeria monocytogenes brain abscess based on imaging and antimicrobial response.

Conclusions:

  • Tract-based imaging findings coupled with a selective antimicrobial response can suggest Listeria monocytogenes brain abscess even without definitive pathogen identification.
  • Relapse after treatment cessation underscores the importance of sustained antimicrobial therapy.
  • Pulmonary arteriovenous malformation may represent a potential predisposing factor for brain abscess formation.
Keywords:
Brain abscessCulture-negativeListeria monocytogenesPulmonary arteriovenous malformation

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