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[Weber syndrome caused by Listeria abscess]
L Milandre1, P Pestre, D Figarella-Branger
1Service de Neurologie, CHU Timone.
Abstract:
A 63-year old diabetic man presented with left Weber's syndrome and meningitic syndrome. CSF examination showed moderate lymphocytic pleocytosis and elevated proteins with normal glucose content and sterile culture. Blood cultures yielded Listeria monocytogenes and the patient received ampicillin. While his neurological condition had partially improved, he died of heart failure. Several mesencephalic abscesses were found at autopsy.
Insights
A diabetic man developed Listeria monocytogenes meningitis, presenting with Weber's syndrome and neurological symptoms. Despite treatment, he died from heart failure, with autopsy revealing mesencephalic abscesses.
Area of Science:
- Neurology
- Infectious Diseases
- Internal Medicine
Background:
- Listeria monocytogenes is a significant cause of bacterial meningitis, particularly in immunocompromised individuals.
- Weber's syndrome, a rare brainstem stroke, can present with diverse neurological deficits.
- Meningitic syndrome involves inflammation of the meninges, often indicated by pleocytosis and elevated protein in cerebrospinal fluid.
Observation:
- A 63-year-old diabetic patient presented with symptoms of left Weber's syndrome and meningitis.
- Cerebrospinal fluid analysis revealed lymphocytic pleocytosis and elevated protein, with normal glucose and negative cultures.
- Blood cultures confirmed Listeria monocytogenes infection.
Findings:
- The patient received ampicillin for Listeria monocytogenes meningitis.
- Neurological symptoms showed partial improvement during treatment.
- The patient ultimately succumbed to heart failure.
Implications:
- This case highlights the potential for Listeria monocytogenes to cause severe neurological complications, including brain abscesses.
- Early diagnosis and appropriate antibiotic therapy are crucial for managing Listeria meningitis.
- The case underscores the importance of considering infectious etiologies in patients with complex neurological presentations, even in the presence of other comorbidities.