Listeria monocytogenes Brain Abscess Mimicking Ischemic Stroke in an Immunocompromised Patient: A Case Report

  • Angeliki Tsifi Intensive Care Unit, General Hospital of Nea Ionia Konstantopouleio-Patision, Athens, Greece https://orcid.org/0000-0003-2421-0849
  • Stavroula Panagiota Lontou First Department of Internal Medicine, Laiko General Hospital of Athens, Athens, Greece
  • Maria Triantafyllou First Department of Internal Medicine, Laiko General Hospital of Athens, Athens, Greece
  • Sevastianos Chatzidavid First Department of Internal Medicine, Laiko General Hospital of Athens, Athens, Greece
  • Dimitrios Theodoridis Hematology Department, General Hospital of Nea Ionia Konstantopouleio-Patision, Athens, Greece
  • Marina Skouloudi First Department of Internal Medicine, Laiko General Hospital of Athens, Athens, Greece
  • Marina Mantzourani First Department of Internal Medicine, Laiko General Hospital of Athens, Athens, Greece
DOI: https://doi.org/10.7175/cmi.v13i1.1420
Keywords: Listeria, Listeria monocytogenes, Brain abscess, Stroke, Immunosuppression

Abstract

Listeria monocytogenes (L. monocytogenes) is a Gram-positive bacillus that infects immunocompromised persons, neonates, pregnant women and, occasionally, previously healthy individuals. L. monocytogenes brain abscesses are particularly rare.

We present a 62-year-old female on corticosteroid treatment due to a recent diagnosis of autoimmune hepatitis, who suddenly developed right hemiparesis mimicking a stroke. A brain computerized tomography (CT) scan revealed a brain abscess and the blood cultures drawn yielded L. monocytogenes. A conservative treatment without surgical intervention was selected. The patient was commenced on intravenous ampicillin and gentamicin and showed remarkable improvement. She was successfully discharged on oral amoxicillin with probenecid. Since the subsequent magnetic resonance imaging (MRI) study and CT scans exhibited reduction in the size of the abscess, the antimicrobial treatment was discontinued after a three-month period. The patient underwent regular follow-up visits with no signs of relapse.

References

L1. Limmahakhun S, Chayakulkeeree M. Listeria monocytogenes brain abscess: two cases and review of the literature. Southeast Asian J Trop Med Public Health 2013; 44: 468-78

Sakarunchai I, Saeheng S, Oearsakul T, et al. Listeria monocytogenes brain abscess on MR imaging mimicking the track of a migrating worm like a sparganum: A case report. Interdisciplinary Neurosurgery: Advanced Techniques and Case Management 2016; 5: 9-11; https://doi.org/10.1016/j.inat.2016.03.008

Cone LA, Leung MM, Byrd RG, et al. Multiple cerebral abscesses because of Listeria monocytogenes: three case reports and a literature review of supratentorial listerial brain abscess(es). Surg Neurol 2003; 59: 320-8; https://doi.org/10.1016/S0090-3019(03)00056-9

Tiri B, Priante G, Saraca LM, et al. Listeria monocytogenes Brain Abscess: Controversial Issues for the Treatment- Two Cases and Literature Review. Case Rep Infect Dis 2018; 2018: 6549496; https://doi.org/10.1155/2018/6549496

Al-Khatti AA, Al-Tawfiq JA. Listeria monocytogenes brain abscess in a patient with multiple myeloma. J Infect Dev Ctries 2010; 4: 849-51; https://doi.org/10.3855/jidc.898

Marini S, Caruso A, Falcini M, et al. Listeria monocytogenes brainstem infection (rhomboencephalitis) mimicking ischemic stroke. J Clin Neurosci 2014; 21: 2006-8; https://doi.org/10.1016/j.jocn.2014.03

Moragas M, Martinez-Yelamos S, Murillo O, et al. Brain abscess due to Listeria monocytogenes in adults: Six cases and review of the literature. Enferm Infecc Microbiol Clin 2010; 28: 87-94; https://doi.org/10.1016/j.eimc.2009.01.011

Tseng J, Strasfeld LM, Orloff SL. An Unusual Presentation of Altered Mental Status After Orthotopic Liver Transplantation: Listeria Brain Abscess. Transplantation 2013; 95: e72-e73; https://doi.org/10.1097/TP.0b013e318292d20

Coste JF, Duval V, Nguyen Y, et al. Unusual location of a brain abscess due to Listeria monocytogenes. Pathol Biol (Paris) 2012; 60: e45-8; https://doi.org/10.1016/j.patbio.2011.05.006

Clauss HE, Lorber B. Central nervous system infection with Listeria monocytogenes. Curr Infect Dis Rep 2008; 10: 300; https://doi.org/10.1007/s11908-008-0049-0

Dee RR, Lorber B. Brain abscess due to Listeria monocytogenes: case report and literature review. Rev Infect Dis 1986; 8: 968-77; http://www.jstor.org/stable/4453988

Published
2019-05-21
Issue
Vol 13 No 1 (2019)
Section
Case report

Copyright (c) 2019 The Authors

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors who publish with this journal agree to the following terms:
    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non-Commercial 4.0 Licence that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. The Publication Agreement can be downloaded here, and should be signed by the Authors and sent to the Publisher when the article has been accepted for publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
    4. Authors are permitted to post their work online after publication (the article must link to publisher version, in html format)
Statistics
Abstract: 274 views
HTML: 78 views
PDF: 107 views