Worm-like appearance of Listeria monocytogenes brain abscess: presentation of three cases

Slezák, Ondřej; Žižka, Ján; Kvasnička, Tomáš; Dvořáková, Radka; Česák, Tomáš; Ryšková, Lenka; Ryška, Pavel; Eliás, P

doi:10.1007/s00234-020-02441-9

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…Listeria brain abscess affects more often the brain stem, followed by supratentorial white matter and cerebellar hemispheres [6]. The radiological appearance is similar to that of other brain abscesses, but with some specific patterns, as reported by Slezák et al [15]: irregular formations, revealing the characteristic worm-like tubular pattern of curvilinear arrangement. Some authors suggest that the axonal invasion is the pathological substrate of the multi-tubular appearance of the LM abscess in the imaging [16].…”

Section: Discussionsupporting

confidence: 60%

Brain Abscess Caused by Listeria Monoscytogenes with An Unlikely Evolution: Case Report and Literature Review

Baayoud,

Bouras,

Delvalée

et al. 2024

EJMED

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Introduction: Listeria monocytogenes (LM) is an anaerobic gram-positive bacillus, that enters the host body mainly through the intestine. Brain abscesses due to LM are extremely rare and are mostly seen in patients with risk factors. Case report: We present the case of a 70-year-old patient with a history of rheumatoid arthritis who presented an acute neurological deficit, with no headaches or fever. The diagnosis was confirmed after an open surgical biopsy. The patient underwent ampicillin treatment for four weeks, with an unfavorable evolution. Conclusion: L. monocytogenes brain abscess is an uncommon pathology, with a poor prognosis. Surgery combined with antibiotics improves the outcome.

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Section: Discussionsupporting

confidence: 60%

Brain Abscess Caused by Listeria Monoscytogenes with An Unlikely Evolution: Case Report and Literature Review

Baayoud,

Bouras,

Delvalée

et al. 2024

EJMED

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“…They reported three brain abscess cases caused by L monocytogenes with these characteristics radiological findings. Interestingly, one of three is a middle-aged immunocompetent woman whose MRI demonstrated multiple worm-like prominences and a thin rim of enhancement [14] . Our case report supports listerial brain abscess data that can present with conglomerate ring and tract-like enhancement appearances.…”

Section: Discussionmentioning

confidence: 99%

Conglomerate ring and tract-like enhancement lesions: Neuroimaging in Listeria monocytogenes brain abscess

Thiankhaw

Wantaneeyawong

Madla

2022

Radiology Case Reports

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This report aims to describe a characteristic neuroimaging of Listeria monocytogenes brain abscess in predisposed patients. A 56-year-old man presented with fever and headache for 3 weeks. Cerebrospinal fluid (CSF) revealed pleocytosis with lymphocytosis, high protein, and low glucose. Both hemoculture and CSF culture yielded L monocytogenes. Another case is a 23-year-old woman with systemic lupus erythematosus, who presented with fever, headache and left hemiparesis. CSF showed pleocytosis with polymorphonuclear cells predominance and low glucose. Hemoculture positive for L monocytogenes. Their MRI brain revealed conglomerate ring and tract-like enhancement lesions at the right parietotemporal lobe. The patients were diagnosed with L monocytogenes brain abscess. They received a high dose of ceftriaxone and ampicillin for 6 weeks. The clinical and MRI at the end of treatment was a substantial improvement. Our information can help the physician concern about this pathogen in patients who presented with brain abscess and had these MRI findings.

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“…Case reports commonly describe ring-enhancing abscesses with a serpiginous ("worm-like" or "tubular") appearance with surrounding edema. [4,5] Definitive diagnosis requires confirmation of the pathogen in CSF testing. However, initial CSF studies can be normal or nonspecific, as was the case in our patient.…”

Section: Discussionmentioning

confidence: 99%

Clinical Reasoning: A 29-Year-Old Man With Fevers and Rapidly Progressive Cranial Neuropathies

et al. 2021

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A 29-year-old man with no prior known medical diagnoses presented to the emergency department with 5 days of fevers, chills, vomiting, headache, and neck pain followed by voice changes, difficulty swallowing, and intractable hiccups. The patient denied vision changes, weakness, numbness, recent travel, new medications, or illicit drug use. He had no personal or family history of neurologic illness. On questioning concerning possible toxic exposure, he noted recent consumption of sushi and raw meat at a restaurant; a friend who had eaten with him also experienced gastrointestinal illness after that meal.On examination, the patient was diaphoretic with a temperature of 39.4°C. He had nystagmus with left-beat in left gaze, right-beat in right gaze, and downbeat in the primary position. Ocular motility was full. Facial sensation was decreased in the left V2 and V3 distributions. There was subtle flattening of the right nasolabial fold. His speech was hoarse, dysphonic, and highpitched. The uvula deviated to the right on palate elevation testing. There was subtle pronation in the left upper extremity. Sensation to light touch was decreased in the left extremities in a nondermatomal pattern. He leaned towards the right on Romberg testing. His gait was widebased and unsteady. Questions for Consideration:1. How do the examination findings localize the lesion? 2. What is the differential diagnosis? 3. What are the next steps in evaluation?GO TO SECTION 2

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Worm-like appearance of Listeria monocytogenes brain abscess: presentation of three cases

Cited by 7 publications

References 10 publications

Brain Abscess Caused by Listeria Monoscytogenes with An Unlikely Evolution: Case Report and Literature Review

Brain Abscess Caused by Listeria Monoscytogenes with An Unlikely Evolution: Case Report and Literature Review

Conglomerate ring and tract-like enhancement lesions: Neuroimaging in Listeria monocytogenes brain abscess

Clinical Reasoning: A 29-Year-Old Man With Fevers and Rapidly Progressive Cranial Neuropathies

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