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Listeria monocytogenes rhomboencephalitis with cranial-nerve palsies: a case report
D N Shaffer1, D A Drevets, R W Farr
1National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Md., USA.
Abstract:
Listeria monocytogenes rhomboencephalitis is an uncommon complication of L. monocytogenes meningitis. It presents in a typical biphasic pattern characterized by a non-specific prodromal period followed by any combination of asymmetrical, cranial-nerve palsies; cerebellar signs; hemiparesis or hypesthesia; and diminished consciousness. The survival rate is greater than 70% when appropriate antibiotic therapy is initiated early. However, approximately 60 percent of the survivors develop neurological sequelae. We present the case of a 33-year-old woman who developed L. monocytogenes meningitis with subsequent rhomboencephalitis and cranial-nerve palsie, and review the literature on this syndrome.
Insights
Listeria monocytogenes meningitis can lead to uncommon rhomboencephalitis, causing neurological issues. Early antibiotics improve survival but neurological sequelae remain common in survivors.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Listeria monocytogenes meningitis is a serious infection.
- Rhomboencephalitis is an infrequent complication of Listeria meningitis.
Observation:
- The study details a case of a 33-year-old woman with Listeria meningitis and subsequent rhomboencephalitis.
- Rhomboencephalitis typically presents with a biphasic pattern, including cranial-nerve palsies, cerebellar signs, and altered consciousness.
Findings:
- Early and appropriate antibiotic therapy for Listeria monocytogenes meningitis is associated with a survival rate exceeding 70%.
- Despite high survival rates, approximately 60% of survivors experience long-term neurological deficits.
Implications:
- Prompt diagnosis and treatment are crucial for improving outcomes in Listeria monocytogenes meningitis and rhomboencephalitis.
- Further research may focus on mitigating neurological sequelae in survivors of this infection.