Listeria rhombencephalitis mimicking a demyelinating event in an immunocompetent young patient. (January 2017)

• Record Type: Journal Article
• Authors: Décard, Bernhard F; Thöne, Jan; Haghikia, Aiden; Börnke, Christian; Anders, Agnes; Lukas, Carsten; Gold, Ralf
• Is Part Of: Multiple sclerosis. Volume 23:Number 1(2017)
• Page Start: 123
• Page End: 125
• Publication Date: 2017-01
• Subjects: Listeria monocytogenes -- rhombencephalitis -- brainstem -- clinically isolated syndrome -- multiple sclerosis -- alemtuzumab; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458516650522
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Listeriosis caused by listeria monocytogenes (LM) is a potentially lethal foodborne infection of the central nervous system (CNS) and the third most common cause of bacterial meningitis. Foods most commonly implicated are soft cheeses, raw or ready-to-eat meat and pre-processed foods. The incubation time is between 11 and 70 days. Rarely LM rhombencephalitis (RE) can occur, which typically has a biphasic course with non- specific prodromal symptoms like fever, malaise, fatigue, headache, nausea and vomiting followed by cranial nerve palsies, ataxia and hemi- or tetraparesis. Objective: To report a 31-year old immunocompetent female developing a severe abscessing RE caused by LM, which was initially assessed as a relapse after a clinically isolated syndrome (CIS). Methods: Case report. Results: Patients with CIS or multiple sclerosis, who present with brainstem symptoms should be evaluated carefully. The presence of clinical and paraclinical red flags in the diagnostic evaluation of a suspected CNS white matter disease should raise the awareness of clinicians for potential differential diagnoses.