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An unusual presentation of Listeria monocytogenes rhombencephalitis
Affiliations- First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Department of Neurology, Military Institute of Aviation Medicine, Warsaw, Poland
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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.
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.
Keywords
Listeria monocytogenes, Rhombencephalitis, Stroke mimics, Brain infection
About this articleTitle
An unusual presentation of Listeria monocytogenes rhombencephalitis
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
180-183
Page views
430
Article views/downloads
809
DOI
10.1016/j.pjnns.2016.12.004
Bibliographic record
Neurol Neurochir Pol 2017;51(2):180-183.
Keywords
Listeria monocytogenes
Rhombencephalitis
Stroke mimics
Brain infection
Authors
Albert Acewicz
Grzegorz Witkowski
Rafal Rola
Danuta Ryglewicz
Halina Sienkiewicz-Jarosz
