Vol 51, No 2 (2017)

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An unusual presentation of Listeria monocytogenes rhombencephalitis

Albert Acewicz1, Grzegorz Witkowski1, Rafal Rola12, Danuta Ryglewicz1, Halina Sienkiewicz-Jarosz1
DOI: 10.1016/j.pjnns.2016.12.004
Neurol Neurochir Pol 2017;51(2):180-183.

Abstract

We describe a case of 52-year-old woman with a medical history of Crohn's disease presented abrupt fever, asymmetrical multiple cranial nerve palsies and focal neurological symptoms localized to the brainstem. The patient was initially diagnosed with ischaemic stroke, because of acute clinical course and results of neuroimaging. Cerebrospinal fluid analysis revealed mild infection with negative Gram staining and culture. Final diagnosis of Listeria monocytogenes brainstem infection (rhombencephalitis) was set up on the basis of further clinical course and positive blood cultures. Listerial rhombencephalitis should be kept in mind in immunocompromised adult patients who develop fever, asymmetrical multiple cranial nerve palsies and focal neurological symptoms localized to the brainstem even without typical neuroimaging, cerebrospinal fluid findings and negative cultures. Early diagnosis and adequate antibiotic treatment is of crucial importance.

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Neurologia i Neurochirurgia Polska