title: An unusual presentation of Listeria monocytogenes rhombencephalitis.
abstract: We describe a case of 52-year-old woman with a medical history of Crohn's disease presented abrupt fever, asymmetrical multiple cranial nerve palsies and focal neurological symptoms localized to the brainstem. The patient was initially diagnosed with ischaemic stroke, because of acute clinical course and results of neuroimaging. Cerebrospinal fluid analysis revealed mild infection with negative Gram staining and culture. Final diagnosis of Listeria monocytogenes brainstem infection (rhombencephalitis) was set up on the basis of further clinical course and positive blood cultures. Listerial rhombencephalitis should be kept in mind in immunocompromised adult patients who develop fever, asymmetrical multiple cranial nerve palsies and focal neurological symptoms localized to the brainstem even without typical neuroimaging, cerebrospinal fluid findings and negative cultures. Early diagnosis and adequate antibiotic treatment is of crucial importance.
authors.affiliation: First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland. Electronic address: aacewicz@ipin.edu.pl.
authors.forename: Albert
authors.initials: A
authors.lastname: Acewicz
authors.affiliation: First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Witkowski
authors.affiliation: First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Neurology, Military Institute of Aviation Medicine, Warsaw, Poland.
authors.forename: Rafal
authors.initials: R
authors.lastname: Rola
authors.affiliation: First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Ryglewicz
authors.affiliation: First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: Halina
authors.initials: H
authors.lastname: Sienkiewicz-Jarosz
mesh_terms: D003424:Crohn Disease / Q000150:complications; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008584:Meningitis, Listeria / Q000175:diagnosis*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis; D012249:Rhombencephalon / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: Brain infection; Listeria monocytogenes; Rhombencephalitis; Stroke mimics