[Headaches and aphasia in an immunocompromised patient].
We report the case of a 81-year-old, immunocompromised Patient, admitted to our hospital with new-onset headaches and word-finding difficulties. The MRI of the brain revealed a temporal mass on the left with marginal contrast-enhancement. During the next days Listeria monocytogenes grew in the bloodcultures so that the diagnosis of a brain-abscess caused by Listeria was established. Due to the localisation, surgical drainage of the abscess was not possible, so that a prolonged antibiotic therapy lasting over 4.5 months was initiated. The MRI after therapy demonstrated no abscess persistence. Listeria mostly cause infections in the immunocompromised, elderly, newborn or pregnant host. Next to bacteraemia without a focus, CNS-invasion with meningitis, meningoencephalitis or less frequent abcess-formation (5-10%) is the most important manifestation.
Tschudin
S
S
Klinik für Infektiologie und Spitalhygiene, Universitätsspital Basel.
Laifer
G
G
Orasch
C
C
Nüesch
R
R
D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology*; D001284:Atrophy; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis; D001921:Brain / Q000473:pathology; D001922:Brain Abscess / Q000175:diagnosis*; D003093:Colitis, Ulcerative / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008584:Meningitis, Listeria / Q000175:diagnosis*; D009894:Opportunistic Infections / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
D007166:Immunosuppressive Agents; D001379:Azathioprine