Mar 24, 2020

Acute ischaemic stroke in Listeria monocytogenes meningoencephalitis

BJR Case Reports
Surrin S DeenGunaratnam Gunathilagan

Abstract

Listeria monocytogenes is the third most frequent cause of bacterial meningitis and has a predilection for elderly patients and the immunosuppressed. A small number of patients with Listeria monocytogenes meningoencephalitis have previously been reported to experience stroke-like symptoms that were attributed to microabscess formation and the mass effect of collections of infection in the brain. These infections led to temporary neurological deficits that resolved with antimicrobial treatment, rather than to true strokes with permanent neurological deficits. This report discusses the case of an 80- year-old male, who was immunosuppressed with mesalazine for the treatment of Crohn's disease, and who went on to develop Listeria monocytogenes meningoencephalitis. 1 week into his admission, for antibiotic therapy, the patient began to experience new onset right upper limb weakness, nystagmus and past pointing. These symptoms were initially thought to be a complication of the infection. However, subsequent diffusion-weighted MRI revealed that the patient had more likely suffered an acute ischaemic event and a contrast-enhanced MRI performed later could not detect any abscess or large infective focus in a region that could explain th...Continue Reading

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Mentioned in this Paper

Magnetic Resonance Imaging
Diffusion Weighted Imaging
Hospital Admission
Ischemia
Diagnostic Imaging
Cerebrovascular Accident
Listeriosis
Complication
Acute Cerebrovascular Accidents
Brain

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