Listeria brainstem encephalitis and myelitis in a young previously healthy adult
Keywords:
brainstem encephalitis, myelitis, listeriaAbstract
We report the case of a previously healthy 34-year old man, who presented with signs of brainstem involvement. Two weeks previously, he had been suffering from non-specific systemic illness. The initial Magnetic Resonance Imaging (MRI) exam and cerebrospinal fluid (CSF) findings were suggestive of multiple sclerosis. Corticosteroids were given. The patient developed a febrile reaction, with signs of meningeal irritation and impaired consciousness. Listeria was cultured from the CSF, and ampicillin and ceftriaxone were given for five weeks. There was a favourable clinical course.
Two weeks after stopping therapy, signs of spinal cord involvement appeared. He was treated once again with ampicillin and ceftriaxone, associated with gentamicin and trimethoprim/sulpfamethoxazole. There was clinicai improvement but neurological sequelae remain: gait ataxia, bladder and sexual dysfunction. Investigation did not reveral any kind of immunosupression or underlying disease.
A brief review of listerial brainstem encephalitis (rhombencephalitis) is made.
Downloads
References
Pinéde L, Manquat G, Barnoud O, Croize J, Guignier M, Stahl JP, Micoud M. Listériose neuroméningée de l 'adulte. Aspects cliniques et apport du cotrimoxazole en monothérapie. Presse Méd I 993;22: 1385-1390.
Pilly E. Infections a Listeria, in Pilly E: Maladies lnfectieuses, I Od ed. Ed C. et R., 1988; 169-172.
Jensen A, Frederiksen W, Gerner-Smidt P. Risk factors for Listeriosis in Oenmark, 1989-1990. Scand J Infect Dis 1994;26: 171-178.
Armstrong RW, Fung PC. Brainstem encephalitis (Rhombencephalitis) due to Listeria monocytogenes: case report and review. Clin lnfect Ois 1993;16: 689-702.
Lazanas M, Perronne C, Leport C, Salmon-Ceron O, Bricaire F, Vil de JL. Les listérioses neuroméningées de l 'adulte. Aspects cliniques, biologiques et thérapeutiques à propos de 36 observations. Ann Med Interne 1991;142 (2): 95-98.
McLauchlin. Human listeriosis in Britain, 1967-85, a summary of 722 cases. 2. Listeriosis in non-pregnant individuais, a changing paliem of infection and seasonal incidence. Epidemio! Infect 1990;104: 191-201.
Ourand ML, Caderwood SB, Weber OJ, Miller SI, Southwick FS, Caviness VS, Swartz MN. Acute bacterial meningitis in adults. A review of 493 episodes. New England J Med 1993;328: 21-28.
Uldry PA, Kuntzer T, Bogousslavsky J, Regli F, Miklossy J, Bille J, Francioli P, Janzer R. Early symptoms and outcome of Listeria monocytogenes rhombencephalitis 14 adult cases. J Neural 1993;240 235-242.
Faidas A, Shepard DL, Lim J, Nelson JE, Baddour LM. Magnetic resonance imaging in listerial brainstem encephalitis (letter). Clin lnfect Dis 1993,16( 1 ): 186-187.
Malvy D, Dessalles PH, Bailly A, Laffont P, Monseau Y, Bonhoure JB. Failure of thiamphenicol in a penicilin-allergic patient with Listeria meningoencephalitis - delayed cure following penicillin desensitization. lntensive Care Med I 992;18: 485-487.
Khan SA, Pace JE, Cox ML. Listeria rhombencephalitis in a previously healthy adult (letter). Postgrad Med J l 992;68(799): 391-392.
Bianchi G, Appollonio 1, Piolti R, Pozzi C, Frattola L. Listeria rhoinbencephalitis: report of two cases with early diagnosis and favourable outcome. Clin Neural Neurasurg 1995;4: 344-348.
King SJ, Jeffree MA MRI of an abscess of the cervical spinal cord in a case of Listeria meningoencephalomyelitis. Neuraradiology 1993;35: 495-496.
Morrison RE, Brown J, Gooding RS. Spinal cord abscess caused by Listeria monocytogenes. Arch Neural 1980;37: 243-244.
Skogberg K, Syrjanen J, Jahkola M, Renkonen O, Paavonen J, Ahonen J, Kontianen S, Ruutu P, Valtonen V. Clinical presentation and outcome of Listeriosis in patients with and without immunosupressive therapy. Clin Infect Dis 1992;14: 815-821.
Masud T, Somerville K. Listeria meningitis - neurological and psychiatric sequelae. Postgrad Med J 1993;69: 80-81.
Additional Files
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
