Presentation
Fever for last 15 days and altered mental status for last 2 days.
Patient Data
Multiple patchy areas of signal alteration in the left frontal lobe, bilateral thalamic-capsular, midbrain, pons, and bilateral deep cerebellar white matter regions, appear hyperintense on T2W/FLAIR images. Multiple small patchy nodular diffusion restrictions are seen in these areas. Small area hemorrhage is also seen in the left thalamus-capsular region.
CSF analysis is in favor of bacterial etiology.
Rapid meningitis PCR panel detects listeria monocytogenes.
Case Discussion
Imaging findings and CSF analysis are suggestive of listeria rhombencephalitis.
Listeria monocytogenes, an anaerobic bacterium, is cited as the most common etiology for rhombencephalitis and is typically seen in the elderly. It has high mortality (~50%) and frequent serious sequelae for survivors (~60%).
Co-authors:
Dr. Deepa N. A (DM Neurology)
Dr. Sanaullah Mudassir (DM Neurology)
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