Aggressive brainstem listeria abscess in an immunocompetent individual: A case report

Listeria monocyotogenes, a gram-positive bacterium is transmitted to humans through ingestion of contaminated foods, including deli meats, soft cheeses, and raw vegetables but can also thrive in soil, water, sewage, manure and animal feed. Its infection in immunocompetent patients is fairly limited to gastrointestinal distress but carries a high mortality rate in immunocompromised patients especially when affecting the central nervous system. We present a challenging case of an immunocompetent patient in their late 50s with neurolisteriosis presenting as multifocal brainstem abscesses with an extensive negative infectious workup and complex antibiotic regimen. This case underscores the diagnostic and therapeutic difficulties of managing invasive neurolisteriosis and aims to enhance critical thinking, particularly in the context of recent recurring listeria outbreaks. Despite being critically ill for months, this patient has had a dramatic recovery and is a reminder that neurologic infections can ultimately be associated with good outcome if the infection is aggressively and promptly treated.