Summary
We report a case of previously healthy student with acute rhombencephalitis and brainstem
abscess caused by Listeria monocytogenes. The disease begun with uncharacteristic prodromal symptoms of gastrointestinal infection
followed by headache and vertigo. After hospital admission the patient rapidly deteriorated,
presenting pronounced dysphagia and respiratory failure requiring mechanical ventilation.
The diagnosis was established upon clinical symptoms of infection, brainstem involvement,
typical MRI findings and positive for L. monocytogenes blood culture. Infection was complicated by acute, demyelinating neuropathy, diagnosed
upon clinical symptoms of frail palsy confirmed by ENG. Initially introduced empirical
doxycyclin/ceftriaxon treatment was subsequently changed to targeted ampicillin/gentamycin
therapy, mechanical ventilation, intravenous human immunoglobulin treatment, tracheostomy
and endoscopic gastrostomy. Prolonged dysphagia resolved after rehabilitation. After
one year the patient remains well with only slight dysmetria.
Keywords
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Article Info
Publication History
Accepted:
August 31,
2005
Identification
Copyright
© 2006 The British Infection Society. Published by Elsevier Inc. All rights reserved.
