title: Listeria rhombencephalitis mimicking a demyelinating event in an immunocompetent young patient.
abstract: 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.
  
  
  
  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).
  
  
  
  Case report.
  
  
  
  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.
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany/Department of Neurology, University Hospital Basel, Basel, Switzerland.
authors.forename: Bernhard F
authors.initials: BF
authors.lastname: Décard
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany/Department of Neurology, University Hospital Essen, Essen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Thöne
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors.forename: Aiden
authors.initials: A
authors.lastname: Haghikia
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Börnke
authors.affiliation: Department of Medical Microbiology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Agnes
authors.initials: A
authors.lastname: Anders
authors.affiliation: Department of Diagnostic and Interventional Radiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Lukas
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000175:diagnosis*; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology
keywords: Listeria monocytogenes; alemtuzumab; brainstem; clinically isolated syndrome; multiple sclerosis; rhombencephalitis