[Abscessing rhombencephalitis caused by Listeria in an iummunodepressed patient].
The cerebral trunk infection by Listeria monocytogenes is a very rare process, with only 24 described cases and only 2 in immunodepressed patients. We present a new case of cerebral trunk encephalitis caused by Listeria in a patient diagnosed of Polyarteritis nodosa on steroids and cyclophosamide treatment and fatal evolution, and whose hemoculture, spinal fluid culture and cranial CT scan did not contribute to the diagnosis. A necrotizing lesion in the protuberance with mesencephalic extension was observed in the necropsy study in which intra- and extracellular Gram + and silver positive bacilli were detected. Since L. monocytogenes was suspected as the causative agent, indirect immunofluorescence was performed on histological preparations with hyperimmune anti-L. monocytogenes serum giving a clearly positive result. In our case, this technique permitted the etiological diagnosis in the absence of positive cultures.
Villar Rodríguez
J L
JL
Departamento de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla.
Jiménez Mejías
M E
ME
Andreu Alvarez
J
J
Cuello Contreras
J A
JA
Andrada Becerra
E
E
Fernández Alonso
J
J
D001228:Aspergillosis / Q000150:complications / Q000473:pathology; D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004660:Encephalitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000209:etiology / Q000473:pathology; D008088:Listeriosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D012249:Rhombencephalon
D003520:Cyclophosphamide; D011241:Prednisone